CMS Price Transparency Data

Blood transfusion

Facility: Multicare Valley Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $820
Cash Discount Price: $856
vs. Medicare Baseline: 1.82x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Multicare Valley Hospital is $820. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $856. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.82x the Medicare baseline. Located in 12606 East Mission Avenue, Spokane Valley, WA.

Cash / Self-Pay

$856

Average discount available for prompt cash payment at this facility.

Insurance Median

$820

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: $856 (190%)

Insurance Median: $820 (182%)

Cash: $856 (190% of Medicare)

Ins. Median: $820 (182% 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
Molina	$312 - $898	69%
Coordinated Care	$315	70%
Wellpoint	$315	70%
UnitedHealthcare	$321 - $1,300	71%
Community Health Plan Of Washington	$331 - $771	73%
Blue Cross Blue Shield	$457	101%
Aetna	$471 - $1,634	104%
Regence	$471	104%
Wellcare	$480	106%
Pacificsource	$573 - $679	127%
Premera	$721 - $1,149	160%
First Choice	$820 - $1,491	182%
Ambetter / Centene	$846	188%
Regence/Asuris	$956	212%
First Health	$1,540	342%
Multiplan/Phcs	$1,540	342%
Kaiser	$1,787	396%
Cigna	$3,317	736%

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 $856.
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 Multicare Valley 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.