CMS Price Transparency Data

Blood transfusion

Facility: Clarinda Regional Health Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $786
Cash Discount Price: $701
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Clarinda Regional Health Center is $786. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $701. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.74x the Medicare baseline. Located in 220 Essie Davison Drive, Clarinda, IA.

Cash / Self-Pay

$701

Average discount available for prompt cash payment at this facility.

Insurance Median

$786

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: $701 (156%)

Insurance Median: $786 (174%)

Cash: $701 (156% of Medicare)

Ins. Median: $786 (174% 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
Ambetter / Centene	$351 - $2,038	78%
Molina Mcr Adv-All Plans	$351 - $1,881	78%
UnitedHealthcare	$351 - $3,724	78%
Blue Cross Blue Shield	$358 - $3,136	79%
Ia Total Care Mcaid-All Plans	$384 - $2,059	85%
Amerigroup Ia Mcaid-All Plans	$388 - $2,079	86%
Geha-All Plans	$681 - $3,645	151%
Coventry Health-All Other Plans	$688 - $3,684	153%
Midlands Choice-All Plans	$695 - $3,724	154%
Multiplan-All Plans	$695 - $3,724	154%

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 $701.
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 Clarinda Regional Health 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.