CMS Price Transparency Data

Blood transfusion

Facility: Marshfield Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,765
Cash Discount Price: $1,868
vs. Medicare Baseline: 3.92x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Marshfield Medical Center is $1,765. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,868. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.92x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$1,868

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,765

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: $1,868 (414%)

Insurance Median: $1,765 (392%)

Cash: $1,868 (414% of Medicare)

Ins. Median: $1,765 (392% 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 392% of the Medicare baseline (a markup of 292%). 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
Security Health Plan (Shp)	$415 - $1,977	92%
Veteran'S Administration (Va Ccn)	$415	92%
Blue Cross Blue Shield	$428 - $3,163	95%
Group Health Cooperative Of Eau Claire	$440 - $1,809	98%
Family Health Center (Fhc)	$983	218%
Amish/Mennonite	$1,081	240%
Sanford Health Plan	$1,081	240%
The Alliance	$1,366 - $1,642	303%
Besse Forest Products	$1,671	371%
Molina Healthcare Of Wi	$1,671	371%
Rice Lake School District	$1,671	371%
Wps Health Insurance	$1,734 - $1,897	385%
Trilogy	$1,769 - $1,887	392%
UnitedHealthcare	$1,789	397%
Medica Of Wi	$1,824 - $1,862	405%
Cigna	$1,848	410%
Healtheos By Multiplan Inc.	$1,848 - $1,868	410%
Corvel	$1,868	414%
First Health	$1,868	414%
Health Partners	$1,868	414%
Three Rivers Provider Network (Trpn)	$1,868	414%
Coventry	$1,887	419%
Health Smart	$1,887	419%
Rising Medical Work Comp	$1,907	423%

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 $1,868.
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 Marshfield 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.