CMS Price Transparency Data

Blood transfusion

Facility: Mercyone Elkader Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $881
  • Cash Discount Price: $778
  • vs. Medicare Baseline: 1.95x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercyone Elkader Medical Center is $881. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $778. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.95x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.
Cash / Self-Pay
$778

Average discount available for prompt cash payment at this facility.

Insurance Median
$881

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: $778 (173%)
Insurance Median: $881 (195%)
Cash: $778 (173% of Medicare)
Ins. Median: $881 (195% 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
Blue Cross Blue Shield $616 137%
Aetna $622 - $881 138%
Medicare (plans) $629 - $647 140%
UnitedHealthcare $660 - $1,047 146%
Iowa Total Care $745 165%
Medicaid / KanCare $756 - $759 168%
Amish Hospital Aid $828 184%
1199 National Benefit Fund $881 195%
Allied Benefit Systems $881 195%
Asr Health Benefits $881 195%
Christian Brother Services $881 195%
Coventry $881 195%
First Health $881 195%
Lucent Health $881 195%
Luminare Health $881 195%
Medical Mutual $881 195%
Meritain $881 195%
Trustmark Small Business Benefits $881 195%
Webtpa $881 195%
Centivo $934 207%
Health Choices $958 213%
Medical Associates $958 213%
Ambetter / Centene $1,046 232%
Geha $1,047 232%
Health Partners $1,152 256%
Auxiant $1,173 260%
Cigna $1,173 260%
Medica $1,173 260%
Midlands $1,173 260%
Midlands Choice $1,173 260%
Crime Victim Assistance $1,197 266%
Iowa Dept Of Public Health $1,197 266%
Claimdoc $1,251 278%
Nova $1,251 278%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 Davidson Street Nw, Elkader, IA 52043
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals