CMS Price Transparency Data

Blood transfusion

Facility: Mercyone Clinton Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $464
  • Cash Discount Price: $3,031
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercyone Clinton Medical Center is $464. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,031. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.03x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$3,031

Average discount available for prompt cash payment at this facility.

Insurance Median
$464

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: $3,031 (672%)
Insurance Median: $464 (103%)
Cash: $3,031 (672% of Medicare)
Ins. Median: $464 (103% 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 - $1,639 2%
Geha $314 - $533 70%
UnitedHealthcare $314 - $1,639 70%
Iowa Total Care $406 90%
Medicaid / KanCare $410 - $412 91%
Bcn Domestic $451 100%
Blue Benefit Administrators Of Massachusetts $451 100%
Blue Care Network $451 100%
Blue Cross Blue Shield $451 - $465 100%
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 $460 - $1,434 102%
Medicare (plans) $460 - $479 102%
Health Choices $464 103%
Medical Associates $464 103%
Preferred Health Choice $474 105%
Amish Hospital Aid $625 139%
Oscar $641 142%
Ambetter / Centene $789 175%
Claimdoc $944 209%
Nova $944 209%
The Alliance $994 221%
1199 National Benefit Fund $1,434 318%
Allied Benefit Systems $1,434 318%
Asr Health Benefits $1,434 318%
Christian Brother Services $1,434 318%
Coventry $1,434 318%
First Health $1,434 318%
Lucent Health $1,434 318%
Luminare Health $1,434 318%
Medical Mutual $1,434 318%
Meritain $1,434 318%
Trustmark Small Business Benefits $1,434 318%
Webtpa $1,434 318%
Health Partners $1,437 319%
Auxiant $1,475 327%
Cigna $1,475 327%
Medica $1,475 327%
Midlands $1,475 327%
Midlands Choice $1,475 327%
Multiplan $1,475 327%
Qualcare $1,475 327%
Usa Managed Care $1,557 345%
Crime Victim Assistance $1,639 364%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals