CMS Price Transparency Data

Blood transfusion

Facility: Franklin General Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $575
Cash Discount Price: $990
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Franklin General Hospital is $575. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $990. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.28x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$990

Average discount available for prompt cash payment at this facility.

Insurance Median

$575

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: $990 (220%)

Insurance Median: $575 (128%)

Cash: $990 (220% of Medicare)

Ins. Median: $575 (128% 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
Medical Associates Mcare	$329 - $552	73%
Mount Carmel Hp-All Plans	$329 - $552	73%
Tricare	$329 - $552	73%
UnitedHealthcare	$329 - $1,146	73%
Amerigroup Mcare	$332 - $557	74%
Wellmark Mcr Adv	$332 - $557	74%
Molina Mcare	$342 - $574	76%
Ambetter / Centene	$344 - $883	76%
American Hp Iowa - All Plans	$346 - $579	77%
Amerigroup Mcaid - All Other Plans	$348 - $582	77%
Molina Mcaid - All Other Plans	$349 - $585	77%
Centivo - All Plans	$494 - $827	110%
Medical Ass Hosp Employer Group	$494 - $827	110%
Oscar - All Plans	$494 - $827	110%
Midlands Choice-All Plans	$576 - $965	128%
Medical Associates Hp-All Other Plans	$700 - $1,172	155%
Preferred Health Choices-All Plans	$700 - $1,172	155%
Splashlight Llc-All Plans	$700 - $1,172	155%
Aetna	$765 - $1,310	170%
Multiplan-All Plans	$782 - $1,310	173%
Wellmark Hmo	$1,313	291%
Wellmark Ppo - All Other Plans	$1,444	320%

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 $990.
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 Franklin General 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.