CMS Price Transparency Data

Blood transfusion

Facility: Novant Health Forsyth Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $563
Cash Discount Price: $586
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Novant Health Forsyth Medical Center is $563. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $586. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.25x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.

Cash / Self-Pay

$586

Average discount available for prompt cash payment at this facility.

Insurance Median

$563

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$450.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $450.73 (100%)

Cash / Self-Pay: $586 (130%)

Insurance Median: $563 (125%)

Cash: $586 (130% of Medicare)

Ins. Median: $563 (125% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $450.73 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Carolina Complete	$91 - $407	20%
Nc Department Of Public Safety	$91 - $856	20%
Amerihealth	$93 - $416	21%
Blue Cross Blue Shield	$93 - $1,580	21%
UnitedHealthcare	$93 - $1,477	21%
Wellcare	$93 - $416	21%
Cigna	$189 - $849	42%
Caresource North Carolina	$196 - $878	43%
Atlantic Corporation Dba Atlantic Packaging	$276 - $1,240	61%
Plotkin Health	$293 - $1,316	65%
Aetna	$301 - $1,755	67%
Amps	$318 - $1,426	71%
Humana	$381 - $1,709	85%
Medcost	$416 - $2,062	92%
Pace Of The Southern Piedmont	$428	95%
Primary Physician Care	$430 - $1,931	95%
Beechstreet	$440 - $1,975	98%
Multiplan	$440 - $1,975	98%
Phcs	$440 - $1,975	98%
Liberty Health	$449	100%
Employers Choice Network	$474 - $2,128	105%
Three Rivers Provider Network	$474 - $2,128	105%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $586.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 36430.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Novant Health Forsyth Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 36430.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.