CMS Price Transparency Data

Blood transfusion

Facility: Novant Health Matthews Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $801
Cash Discount Price: $703
vs. Medicare Baseline: 1.78x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Novant Health Matthews Medical Center is $801. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $703. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.78x the Medicare baseline. Located in 1500 Matthews Twnshp Prkwy Box 3310, Matthews, NC.

Cash / Self-Pay

$703

Average discount available for prompt cash payment at this facility.

Insurance Median

$801

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: $703 (156%)

Insurance Median: $801 (178%)

Cash: $703 (156% of Medicare)

Ins. Median: $801 (178% 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	$98 - $284	22%
Nc Department Of Public Safety	$98 - $857	22%
Amerihealth	$100 - $290	22%
Blue Cross Blue Shield	$100 - $1,573	22%
UnitedHealthcare	$100 - $1,276	22%
Wellcare	$100 - $290	22%
Caresource North Carolina	$250 - $721	55%
Atlantic Corporation Dba Atlantic Packaging	$348 - $1,005	77%
Aetna	$397 - $1,748	88%
Amps	$416 - $1,202	92%
Humana	$429 - $1,573	95%
Pace Of The Southern Piedmont	$429	95%
Cigna	$442	98%
Liberty Health	$450	100%
Plotkin Health	$454 - $1,311	101%
Medcost	$537 - $1,639	119%
Primary Physician Care	$560 - $1,617	124%
Multiplan	$568 - $1,639	126%
Phcs	$568 - $1,639	126%
Employers Choice Network	$734 - $2,119	163%
Three Rivers Provider Network	$734 - $2,119	163%

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 $703.
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 Matthews 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.