CMS Price Transparency Data

Blood transfusion

Facility: Sanford Medical Center Fargo

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $662
Cash Discount Price: $962
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Sanford Medical Center Fargo is $662. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $962. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.47x the Medicare baseline. Located in 801 Broadway North, Fargo, ND.

Cash / Self-Pay

$962

Average discount available for prompt cash payment at this facility.

Insurance Median

$662

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: $962 (213%)

Insurance Median: $662 (147%)

Cash: $962 (213% of Medicare)

Ins. Median: $662 (147% 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
Sanford Health Plan	$42	9%
Blue Cross Blue Shield	$316 - $767	70%
Sanford Health Plan Align	$415	92%
Ucare	$446 - $846	99%
Aetna	$450 - $1,029	100%
Health Partners	$450 - $493	100%
Medicare (plans)	$450	100%
UnitedHealthcare	$450 - $1,048	100%
Primewest	$455 - $459	101%
Medica	$541 - $579	120%
Security Health Plan	$662	147%
Cigna	$1,083	240%
First Choice Health Network	$1,083	240%
Healthez	$1,083	240%
Multiplan	$1,083	240%

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 $962.
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 Sanford Medical Center Fargo 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.