CMS Price Transparency Data

Blood transfusion

Facility: Mountain West Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,455
Cash Discount Price: $1,397
vs. Medicare Baseline: 3.23x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Mountain West Medical Center is $1,455. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,397. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.23x the Medicare baseline. Located in 2055 North Main Street, Tooele, UT.

Cash / Self-Pay

$1,397

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,455

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: $1,397 (310%)

Insurance Median: $1,455 (323%)

Cash: $1,397 (310% of Medicare)

Ins. Median: $1,455 (323% 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 323% of the Medicare baseline (a markup of 223%). 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
Wise/Motivhealth-All Plans	$193 - $2,837	43%
U of Ut-All Plans	$193 - $2,837	43%
Cigna	$211 - $3,095	47%
Dmba-All Plans	$214 - $3,143	47%
Aetna	$223 - $3,274	49%
Pehp-All Plans	$223 - $3,274	49%
Select Health-All Other Plans	$223 - $3,274	49%
UnitedHealthcare	$229 - $3,361	51%
Multiplan Primary Network-All Other Plans	$235 - $3,448	52%
Emi-All Plans	$253 - $3,710	56%
Humana	$253 - $3,710	56%
Multiplan Complimentary Network	$274 - $4,016	61%
Blue Cross Blue Shield	$383 - $447	85%
Select Health McR Adv	$447	99%
Medicare (plans)	$558	124%

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 $1,397.
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 Mountain West 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.