CMS Price Transparency Data

Blood transfusion

Facility: Sheridan Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,089
Cash Discount Price: $971
vs. Medicare Baseline: 2.42x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Sheridan Memorial Hospital is $1,089. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $971. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.42x the Medicare baseline. Located in 1401 W 5Th St, Sheridan, WY.

Cash / Self-Pay

$971

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,089

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: $971 (215%)

Insurance Median: $1,089 (242%)

Cash: $971 (215% of Medicare)

Ins. Median: $1,089 (242% 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 242% of the Medicare baseline (a markup of 142%). 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
Humana	$483	107%
Blue Cross Blue Shield	$951 - $1,063	211%
Wy School Boards-All Plans	$957 - $1,070	212%
UnitedHealthcare	$982 - $1,098	218%
Pacificsource-All Plans	$1,008 - $1,127	224%
C1 Employee - All Plans	$1,031 - $1,153	229%
Casper Opco Llc - All Plans	$1,031 - $1,153	229%
First Health Comm - All Plans	$1,031 - $1,153	229%
Miscellaneous-All Plans	$1,031 - $1,153	229%
Cigna	$1,054 - $1,191	234%
Wise Provider Network-All Plans	$1,066 - $1,191	237%
Ebms - All Plans	$1,089 - $1,217	242%
First Choice Comm - All Plans	$1,089 - $1,217	242%
Phcs Multiplan-All Plans	$1,089 - $1,217	242%
Three Rivers-All Plans	$1,089 - $1,217	242%

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 $971.
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 Sheridan Memorial 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.