CMS Price Transparency Data

Blood transfusion

Facility: Monroe County Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $426
  • Cash Discount Price: $451
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Monroe County Hospital is $426. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $451. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.95x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.
Cash / Self-Pay
$451

Average discount available for prompt cash payment at this facility.

Insurance Median
$426

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: $451 (100%)
Insurance Median: $426 (95%)
Cash: $451 (100% of Medicare)
Ins. Median: $426 (95% 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
Mahp Mcare - All Plans $210 - $422 47%
Tricare $210 - $422 47%
UnitedHealthcare $210 - $954 47%
Va Ccn - All Plans $210 - $422 47%
Amerigroup Mcare $212 - $426 47%
Humana $212 - $426 47%
Wellmark Mcare $212 - $426 47%
Aetna $214 - $944 47%
Iowa Total Care Mcaid - All Plans $250 - $502 55%
Molina Mcaid - All Plans $254 - $509 56%
Amerigroup Mcaid - All Other Plans $257 - $517 57%
Centivo - All Plans $315 - $633 70%
Midlands Choice - All Plans $350 - $703 78%
Preferred Hlth - All Plans $375 - $753 83%
Geha - All Plans $400 - $803 89%
Multiplan - All Plans $450 - $904 100%
Integrated Hp - All Plans $485 - $974 108%
Wellmark Hmo $550 122%
Wellmark Ppo - All Other Plans $593 132%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6580 165Th Street, Albia, IA 52531
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals