CMS Price Transparency Data

Blood transfusion

Facility: Wilkes Regional Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $441
  • Cash Discount Price: $431
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Wilkes Regional Medical Center is $441. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $431. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.98x the Medicare baseline. Located in 1370 West D St, North Wilkesboro, NC.
Cash / Self-Pay
$431

Average discount available for prompt cash payment at this facility.

Insurance Median
$441

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: $431 (96%)
Insurance Median: $441 (98%)
Cash: $431 (96% of Medicare)
Ins. Median: $441 (98% 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.

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
Amerihealth $161 - $501 36%
Carolina Complete $161 36%
Healthblue $161 36%
Partners $161 36%
UnitedHealthcare $163 - $460 36%
Vaya $163 36%
Wellcare $163 36%
Alliance $164 36%
Trillium $166 37%
Medcost $248 - $615 55%
Blue Cross Blue Shield $267 - $503 59%
Aetna $328 - $592 73%
Ambetter / Centene $365 - $525 81%
Healthteam $430 95%
Cigna $452 - $467 100%
Oscar $474 - $560 105%
Directnet $509 113%
Private Healthcare Systems $776 172%
Multiplan $793 176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1370 West D St, North Wilkesboro, NC 28659
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals