CMS Price Transparency Data

Blood transfusion

Facility: Mercyone Oelwein Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,100
Cash Discount Price: $1,650
vs. Medicare Baseline: 2.44x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Mercyone Oelwein Medical Center is $1,100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,650. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.44x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.

Cash / Self-Pay

$1,650

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,100

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: $1,650 (366%)

Insurance Median: $1,100 (244%)

Cash: $1,650 (366% of Medicare)

Ins. Median: $1,100 (244% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 244% of the Medicare baseline (a markup of 144%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Iowa Dept Of Public Health	$9 - $1,197	2%
Medicare (plans)	$457 - $510	101%
Iowa Total Care	$464	103%
Medicaid / KanCare	$471 - $473	104%
Blue Cross Blue Shield	$486	108%
UnitedHealthcare	$520 - $1,033	115%
Aetna	$564 - $1,100	125%
Amish Hospital Aid	$653	145%
Centivo	$736	163%
Ambetter / Centene	$824	183%
Health Choices	$881	195%
Medical Associates	$881	195%
Claimdoc	$986	219%
Nova	$986	219%
Geha	$1,033	229%
1199 National Benefit Fund	$1,100	244%
Allied Benefit Systems	$1,100	244%
Asr Health Benefits	$1,100	244%
Christian Brother Services	$1,100	244%
Coventry	$1,100	244%
First Health	$1,100	244%
Lucent Health	$1,100	244%
Luminare Health	$1,100	244%
Medical Mutual	$1,100	244%
Meritain	$1,100	244%
Trustmark Small Business Benefits	$1,100	244%
Webtpa	$1,100	244%
Health Partners	$1,152	256%
Multiplan	$1,161	258%
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%

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 $1,650.
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 Mercyone Oelwein Medical Center 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.