CMS Price Transparency Data

Blood transfusion

Facility: Sanford Hillsboro

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $871
Cash Discount Price: $845
vs. Medicare Baseline: 1.93x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Sanford Hillsboro is $871. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $845. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.93x the Medicare baseline. Located in 12 Third Street Se, Hillsboro, ND.

Cash / Self-Pay

$845

Average discount available for prompt cash payment at this facility.

Insurance Median

$871

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: $845 (187%)

Insurance Median: $871 (193%)

Cash: $845 (187% of Medicare)

Ins. Median: $871 (193% 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
Blue Cross Blue Shield	$256 - $977	57%
Sanford Health Plan Align	$482	107%
Ucare	$517 - $928	115%
Aetna	$522 - $918	116%
Health Partners	$522 - $824	116%
Medicare (plans)	$522	116%
UnitedHealthcare	$522 - $882	116%
Primewest	$532	118%
Security Health Plan	$581	129%
Sanford Health Plan	$834 - $981	185%
Medica	$871 - $931	193%
First Choice Health Network	$950	211%
Healthez	$950	211%
Multiplan	$950	211%

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 $845.
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 Hillsboro 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.