CMS Price Transparency Data

Blood transfusion

Facility: North Carolina Baptist Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $481
Cash Discount Price: $732
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at North Carolina Baptist Hospital is $481. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $732. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.07x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.

Cash / Self-Pay

$732

Average discount available for prompt cash payment at this facility.

Insurance Median

$481

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: $732 (162%)

Insurance Median: $481 (107%)

Cash: $732 (162% of Medicare)

Ins. Median: $481 (107% 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
Medcost	$282 - $1,000	63%
Blue Cross Blue Shield	$295 - $506	65%
Amerihealth	$322 - $405	71%
Carolina Complete	$322 - $340	71%
Health Blue	$322 - $340	71%
Partners	$322 - $340	71%
Vaya	$325 - $343	72%
UnitedHealthcare	$326 - $1,741	72%
Wellcare	$326 - $423	72%
Alliance	$328 - $346	73%
Trillium	$331 - $350	73%
Aetna	$337 - $1,278	75%
Ambetter / Centene	$384 - $406	85%
Apex	$423	94%
Cigna	$423 - $902	94%
Devoted	$423	94%
Healthteam	$423	94%
Humana	$427 - $822	95%
Medicare (plans)	$427	95%
Oscar	$427 - $541	95%
Liberty	$487	108%
Directnet	$842 - $888	187%
Cone Health	$997 - $1,052	221%
Healthgram	$997 - $1,052	221%
First Carolina Care	$1,139 - $1,202	253%
Private Healthcare Systems	$1,168 - $1,232	259%
Multiplan	$1,281 - $1,353	284%

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 $732.
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 North Carolina Baptist Hospital 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.