CMS Price Transparency Data

Blood transfusion

Facility: Tristar Northcrest Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,650
Cash Discount Price: $3,300
vs. Medicare Baseline: 3.66x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Tristar Northcrest Medical Center is $1,650. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,300. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.66x the Medicare baseline. Located in 100 Northcrest Drive, Springfield, TN.

Cash / Self-Pay

$3,300

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,650

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: $3,300 (732%)

Insurance Median: $1,650 (366%)

Cash: $3,300 (732% of Medicare)

Ins. Median: $1,650 (366% 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 366% of the Medicare baseline (a markup of 266%). 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
United	$226 - $2,791	50%
Molina	$231	51%
Bright Health	$495 - $827	110%
Ambetter / Centene	$637 - $660	141%
Aetna	$792 - $2,303	176%
Cigna	$832 - $3,454	185%
Oscar	$990	220%
Blue Cross Blue Shield	$2,003	444%
City Of Springfield	$2,145	476%
Nhc Advantage, Inc.	$2,550	566%
Humana	$2,569	570%
Multiplan	$2,574 - $2,706	571%

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 $3,300.
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 Tristar Northcrest 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.