CMS Price Transparency Data

Blood transfusion

Facility: Mercyone Waterloo Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $451
  • Cash Discount Price: $2,543
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercyone Waterloo Medical Center is $451. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,543. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.00x the Medicare baseline. Located in 3421 West Ninth Street, Waterloo, IA.
Cash / Self-Pay
$2,543

Average discount available for prompt cash payment at this facility.

Insurance Median
$451

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: $2,543 (564%)
Insurance Median: $451 (100%)
Cash: $2,543 (564% of Medicare)
Ins. Median: $451 (100% 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
Health Choices $268 59%
Medical Associates $268 59%
Geha $332 74%
UnitedHealthcare $332 - $1,139 74%
Aetna $416 - $1,017 92%
Medicare (plans) $416 - $433 92%
Blue Cross Blue Shield $420 - $451 93%
Iowa Total Care $423 94%
Medicaid / KanCare $427 - $428 95%
Bcn Domestic $451 100%
Blue Benefit Administrators Of Massachusetts $451 100%
Blue Care Network $451 100%
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%
Amish Hospital Aid $564 125%
Oscar $651 144%
Centivo $704 156%
Ambetter / Centene $713 158%
Health Partners $747 166%
Auxiant $809 179%
Cigna $809 179%
Medica $809 179%
Midlands $809 179%
Midlands Choice $809 179%
Claimdoc $852 189%
Nova $852 189%
Allied Benefit Systems $1,017 226%
Asr Health Benefits $1,017 226%
Christian Brother Services $1,017 226%
Coventry $1,017 226%
First Health $1,017 226%
Lucent Health $1,017 226%
Luminare Health $1,017 226%
Medical Mutual $1,017 226%
Meritain $1,017 226%
Webtpa $1,017 226%
Iowa Dept Of Public Health $1,139 253%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3421 West Ninth Street, Waterloo, IA 50702
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals