CMS Price Transparency Data

Blood transfusion

Facility: Northern Nevada Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,404
Cash Discount Price: $1,206
vs. Medicare Baseline: 3.11x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Northern Nevada Medical Center is $1,404. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,206. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.11x the Medicare baseline. Located in 2375 E Prater Way, Sparks, NV.

Cash / Self-Pay

$1,206

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,404

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: $1,206 (268%)

Insurance Median: $1,404 (311%)

Cash: $1,206 (268% of Medicare)

Ins. Median: $1,404 (311% 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 311% of the Medicare baseline (a markup of 211%). 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	$32	7%
Smart_Choice	$32	7%
Molina	$33	7%
Silver_Summit	$33	7%
Prominence	$615	136%
Nevada_Preferred_Providers	$799	177%
Cigna	$1,158 - $1,652	257%
United_Healthcare	$1,201	266%
Aetna	$1,404 - $1,496	311%
Business_Coalition	$1,764	391%
Sierra_Health_Plan_Of_Nevada	$1,880	417%
Multiplan	$2,171	482%
Humana	$2,319 - $2,385	514%
Sierra_Health_Options	$3,543	786%

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 $1,206.
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 Northern Nevada 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.