CMS Price Transparency Data

Blood transfusion

Facility: Kossuth Regional Health Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $839
Cash Discount Price: $884
vs. Medicare Baseline: 1.86x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Kossuth Regional Health Center is $839. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $884. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.86x the Medicare baseline. Located in 1515 South Phillips Street, Algona, IA.

Cash / Self-Pay

$884

Average discount available for prompt cash payment at this facility.

Insurance Median

$839

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: $884 (196%)

Insurance Median: $839 (186%)

Cash: $884 (196% of Medicare)

Ins. Median: $839 (186% 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
Mercy One - All Plans	$420	93%
Va Ccn - All Plans	$420	93%
Humana	$424	94%
Amerigroup Mcr Adv - All Other Plans	$428	95%
UnitedHealthcare	$432 - $839	96%
Blue Cross Blue Shield	$526 - $579	117%
Health Partners New Bus - All Other Plans	$774	172%
Midlands Choice - All Plans	$774	172%
Medical Associates - All Plans	$939	208%
Preferred Health - All Plans	$939	208%
Aetna	$1,028 - $1,072	228%
Multiplan - All Plans	$1,050	233%
Health Partners Exisiting Bus	$1,072	238%
Molina Mcaid/Chip - All Plans	$1,138	252%
Amerigroup Mcaid	$1,149	255%

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 $884.
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 Kossuth 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.