CMS Price Transparency Data

Blood transfusion

Facility: Buena Vista Regional Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,968
Cash Discount Price: $1,623
vs. Medicare Baseline: 4.37x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Buena Vista Regional Medical Center is $1,968. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,623. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 4.37x the Medicare baseline. Located in 1525 West 5Th Street, Storm Lake, IA.

Cash / Self-Pay

$1,623

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,968

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: $1,623 (360%)

Insurance Median: $1,968 (437%)

Cash: $1,623 (360% of Medicare)

Ins. Median: $1,968 (437% 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 437% of the Medicare baseline (a markup of 337%). 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
Ambetter / Centene	$1,075 - $2,029	239%
Blue Cross Blue Shield	$1,075 - $2,029	239%
Champus	$1,075	239%
Champva	$1,075	239%
Health Partners	$1,075 - $2,029	239%
Iowa Health Advantage	$1,075 - $2,029	239%
Medicare (plans)	$1,075 - $2,029	239%
UnitedHealthcare	$1,075 - $2,029	239%
Wellcare	$1,075 - $2,029	239%
Wellpoint	$1,075 - $2,029	239%
American Postal Workers	$1,623	360%
Avera	$1,725	383%
Cigna	$1,826	405%
Aetna	$1,968 - $2,029	437%
First Administrators	$1,968	437%
Golden Rule	$1,968	437%
Great West	$1,968	437%
Healthscope	$1,968	437%
Medical Associates	$1,968	437%
Meritain	$1,968	437%
Midlands Choice	$1,968	437%
Humana	$2,029	450%

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 $1,623.
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 Buena Vista Regional 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.