CMS Price Transparency Data

Blood transfusion

Facility: Monument Health Rapid City Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $934
  • Cash Discount Price: $1,125
  • vs. Medicare Baseline: 2.07x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Monument Health Rapid City Hospital is $934. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,125. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.07x the Medicare baseline. Located in 353 Fairmont Blvd, Rapid City, SD.
Cash / Self-Pay
$1,125

Average discount available for prompt cash payment at this facility.

Insurance Median
$934

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: $1,125 (250%)
Insurance Median: $934 (207%)
Cash: $1,125 (250% of Medicare)
Ins. Median: $934 (207% 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 207% of the Medicare baseline (a markup of 107%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Risk Admin Svs [3081167] $40 - $900 9%
UnitedHealthcare $41 - $2,314 9%
Va Black Hills Health Care System 12115 [3081206] $41 - $443 9%
Humana $43 - $2,450 10%
Tricare $315 - $443 70%
Minnesota Health Care Programs 12K16 [3081295] $341 - $825 76%
Blue Cross Blue Shield $443 - $526 98%
Healthpartners [3081368] $443 98%
Medicare (plans) $443 98%
Health Partners Sx009 [3081102] $698 - $1,183 155%
Coresource 38225 [3081146] $731 - $1,769 162%
Govt Employees Health Assn [3081090] $742 - $2,314 165%
National Telephone Cooperative Assn 52103 [3081149] $742 - $2,314 165%
Surest [3081369] $742 - $2,314 165%
United Medical Resources 39026 [3081194] $742 - $2,314 165%
Avera Health Plans 46045 [3081018] $827 - $1,964 183%
Rocky Mountain Admin Llc 83028 [3081168] $900 - $2,178 200%
Medica (Commercial) 94265 [3081118] $934 - $2,259 207%
Employee Benefit Management 12X44 [3081079] $956 - $2,314 212%
Pacificsource Health Plans [3081333] $956 - $2,314 212%
Tlc Advantage Llc [3081189] $979 - $2,559 217%
Aetna $1,012 - $2,450 225%
Group And Pension Administrators Inc [3081098] $1,012 - $2,405 225%
Multiplan Inc 34080 [3081285] $1,012 - $2,405 225%
Sanford Health Plan 91184 [3081174] $1,012 - $2,450 225%
Fedmed Inc [3081283] $1,069 - $2,586 237%
Allied Benefit Systems Inc [3081320] $1,080 - $2,565 240%
Cigna $1,080 - $2,565 240%
Key Benefit Administrators [3081332] $1,080 - $2,565 240%
Meritain Health [3081135] $1,080 - $2,565 240%
Midlands Choice 47080 [3081136] $1,080 - $2,565 240%
Preferred One 41147 [3081160] $1,080 - $2,565 240%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 353 Fairmont Blvd, Rapid City, SD 57701
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals