CMS Price Transparency Data

Blood transfusion

Facility: Mercyone North Iowa Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $471
  • Cash Discount Price: $2,640
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercyone North Iowa Medical Center is $471. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,640. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.04x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$2,640

Average discount available for prompt cash payment at this facility.

Insurance Median
$471

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: $2,640 (586%)
Insurance Median: $471 (104%)
Cash: $2,640 (586% of Medicare)
Ins. Median: $471 (104% 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.

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
Iowa Dept Of Public Health $9 - $2,019 2%
Geha $317 70%
UnitedHealthcare $317 - $2,019 70%
Iowa Total Care $427 95%
Medicaid / KanCare $431 - $433 96%
Bcn Domestic $451 100%
Blue Benefit Administrators Of Massachusetts $451 100%
Blue Care Network $451 100%
Blue Cross Blue Shield $451 - $471 100%
Blue Distinction Transplant $451 100%
Blue Shield - Ca $451 100%
Blue Shield - Id (Regence) $451 100%
Blue Shield - Ny Highmark Northeastern $451 100%
Blue Shield - Ny Highmark Western $451 100%
Blue Shield - Pa (Highmark) $451 100%
Blue Shield - Wa (Regence) $451 100%
Kaiser Domestic $451 100%
Pre-Employment $451 100%
Wc Domestic $451 100%
Aetna $466 - $1,060 103%
Medicare (plans) $466 - $485 103%
Health Choices $517 115%
Medical Associates $517 115%
Centivo $585 130%
Oscar $627 139%
Amish Hospital Aid $632 140%
Ambetter / Centene $799 177%
Claimdoc $956 212%
Nova $956 212%
1199 National Benefit Fund $1,060 235%
Allied Benefit Systems $1,060 235%
Asr Health Benefits $1,060 235%
Christian Brother Services $1,060 235%
Coventry $1,060 235%
First Health $1,060 235%
Lucent Health $1,060 235%
Luminare Health $1,060 235%
Medical Mutual $1,060 235%
Meritain $1,060 235%
Trustmark Small Business Benefits $1,060 235%
Webtpa $1,060 235%
Preferred One $1,312 291%
Health Partners $1,351 300%
Auxiant $1,413 313%
Cigna $1,413 313%
Medica $1,413 313%
Midlands $1,413 313%
Midlands Choice $1,413 313%
Mhnet $1,615 358%
Multiplan $1,817 403%
Crime Victim Assistance $2,019 448%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Fourth Street Sw, Mason City, IA 50401
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals