CMS Price Transparency Data

Blood transfusion

Facility: Knoxville Hospital & Clinics

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $357
Cash Discount Price: $315
vs. Medicare Baseline: 0.79x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Knoxville Hospital & Clinics is $357. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $315. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.79x the Medicare baseline. Located in 1002 South Lincoln Street, Knoxville, IA.

Cash / Self-Pay

$315

Average discount available for prompt cash payment at this facility.

Insurance Median

$357

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: $315 (70%)

Insurance Median: $357 (79%)

Cash: $315 (70% of Medicare)

Ins. Median: $357 (79% 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
Molina Mcaid/Chip - All Plans	$209 - $237	46%
Amerigroup Mcaid	$212 - $240	47%
Iowa Total Care Mcaid - All Plans	$212 - $240	47%
Aetna	$217 - $246	48%
Humana	$217 - $474	48%
UnitedHealthcare	$217 - $516	48%
Amerigroup Mcr - All Other Plans	$219 - $248	49%
Oscar-All Plans	$325 - $368	72%
Health Partners New Bus	$345 - $391	77%
Medical Associates Health Plan-All Other Plans	$370 - $418	82%
Wellmark Hmo 7/1/22	$453	101%
Cigna	$478 - $541	106%
Health Partners-All Other Plans	$478 - $541	106%
Medica Op And Profee Only-All Plans	$478 - $541	106%
Midlands Choice-All Plans	$478 - $541	106%
Wellmark Ppo 7/1/22-All Other Plans	$498	110%

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 $315.
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 Knoxville Hospital & Clinics 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.