CMS Price Transparency Data

Blood transfusion

Facility: Artesia General Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,032
Cash Discount Price: $785
vs. Medicare Baseline: 2.29x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Artesia General Hospital is $1,032. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $785. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.29x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$785

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,032

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: $785 (174%)

Insurance Median: $1,032 (229%)

Cash: $785 (174% of Medicare)

Ins. Median: $1,032 (229% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 229% of the Medicare baseline (a markup of 129%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$271 - $1,064	60%
Molina Healthcare Of New Mexico	$276 - $712	61%
Presbyterian Health Plan	$276 - $424	61%
UnitedHealthcare	$276 - $424	61%
Zelis	$310 - $709	69%
Triwest	$415	92%
Geha	$424 - $1,418	94%
Humana	$424 - $466	94%
Vistacare Hospice	$424	94%
First Health	$438 - $1,596	97%
New Mexico Health Connections	$720	160%
Omni Networks	$794 - $1,241	176%
Providence Risk & Insurance Services	$847 - $1,684	188%
Three Rivers Provider Network	$850 - $1,330	189%
Cigna	$964 - $1,596	214%
Galaxy Health	$1,021 - $1,596	227%
One Health Plan	$1,021 - $1,596	227%
Multiplan	$1,032 - $1,613	229%
United Payors & United Providers	$1,055 - $1,649	234%

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 $785.
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 Artesia General 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.