CMS Price Transparency Data

Blood transfusion

Facility: Alta Vista Regional Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $859
Cash Discount Price: $1,148
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Alta Vista Regional Hospital is $859. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,148. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.91x the Medicare baseline. Located in 104 Legion Drive, Las Vegas, NM.

Cash / Self-Pay

$1,148

Average discount available for prompt cash payment at this facility.

Insurance Median

$859

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: $1,148 (255%)

Insurance Median: $859 (191%)

Cash: $1,148 (255% of Medicare)

Ins. Median: $859 (191% 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
Medicare (plans)	$115 - $4,249	26%
UnitedHealthcare	$115 - $680	26%
Champus	$131 - $4,249	29%
Mcare Mcaid Hmo Dual	$131 - $680	29%
Commercial Hmo Ppo	$223 - $4,249	49%
Medicaid / KanCare	$239 - $4,249	53%
Php Centennial	$239	53%
Workers Comp	$336 - $4,249	75%
Self Pay	$409 - $2,124	91%
Other Covernment	$511 - $4,249	113%
Blue Cross Blue Shield	$614 - $4,249	136%
Mva	$818 - $4,249	181%
Other Government	$818 - $4,249	181%

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 $1,148.
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 Alta Vista Regional 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.