CMS Price Transparency Data

Blood transfusion

Facility: UW Health

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $505
Cash Discount Price: $208
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at UW Health is $505. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $208. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.12x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$208

Average discount available for prompt cash payment at this facility.

Insurance Median

$505

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: $208 (46%)

Insurance Median: $505 (112%)

Cash: $208 (46% of Medicare)

Ins. Median: $505 (112% 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
Blue Cross Blue Shield	$157 - $451	35%
Quartz Fully Insured	$263 - $304	58%
Ecoh	$384 - $690	85%
Hfn	$384 - $690	85%
Alliance Premier Network	$414 - $478	92%
Quartz Aso	$414 - $478	92%
Aetna	$451 - $632	100%
Humana	$451	100%
Medicare (plans)	$451 - $496	100%
Mychoice Wi Medical Adv	$451	100%
UnitedHealthcare	$451 - $673	100%
The Alliance	$532 - $616	118%
Wps Ppo	$586 - $677	130%
Cigna	$605 - $699	134%
Beloit Healt System	$684 - $791	152%
Mercycare	$707 - $818	157%
First Health/Coventry	$745 - $861	165%
Health Payment Systems	$884 - $1,022	196%
Healthsmart	$884 - $1,022	196%
Sheboygan Employers Health Network	$943 - $1,090	209%
Multiplan	$1,054 - $1,219	234%

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 $208.
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 UW Health 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.