CMS Price Transparency Data

Blood transfusion

Facility: Madison County Health Care System

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $335
  • Cash Discount Price: $402
  • vs. Medicare Baseline: 0.74x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Madison County Health Care System is $335. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $402. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.74x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$402

Average discount available for prompt cash payment at this facility.

Insurance Median
$335

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: $402 (89%)
Insurance Median: $335 (74%)
Cash: $402 (89% of Medicare)
Ins. Median: $335 (74% 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
Aetna $97 - $507 22%
Medical Associates Hp - All Plans $97 - $335 22%
Medigold-All Plans $97 - $335 22%
Tricare $97 - $335 22%
UnitedHealthcare $97 - $702 22%
American Hp Mcr Adv-All Plans $102 - $352 23%
Iowa Total Care Mcaid-All Plans $106 - $367 24%
Molina Mcaid/Chip -All Plans $109 - $379 24%
Amerigroup Mcaid-All Plans $112 - $389 25%
Madison County Sheriff-All Plans $112 - $390 25%
Oscar - All Plans $145 - $503 32%
Corvel Wc-All Plans $202 - $702 45%
Choicecare-All Plans $214 - $741 47%
First Choice-All Plans $214 - $741 47%
First Health-All Plans $214 - $741 47%
Integrated Hp-All Plans $214 - $741 47%
Mutual Of Omaha-All Plans $214 - $741 47%
Plaines Health-All Plans $214 - $741 47%
Preferred Hlth Ntwork-All Plans $214 - $741 47%
Principal Healthcare-All Plans $214 - $741 47%
Usa Managed Care-All Plans $214 - $741 47%
Medimore Employee Hp - All Plans $220 - $764 49%
Midlands Choice - All Plans $220 - $764 49%
Benefit Admin Of America-All Plans $225 - $780 50%
Blue Cross Blue Shield $1,313 - $1,444 291%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals