CMS Price Transparency Data

Blood transfusion

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $528
Cash Discount Price: $677
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $528. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $677. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.17x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$677

Average discount available for prompt cash payment at this facility.

Insurance Median

$528

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: $677 (150%)

Insurance Median: $528 (117%)

Cash: $677 (150% of Medicare)

Ins. Median: $528 (117% 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
The Alliance	$362	80%
Security Health Plan (Shp)	$371 - $417	82%
Amish/Mennonite	$392	87%
Quartz	$406 - $417	90%
Humana	$417 - $635	93%
Managed Health Services	$417	93%
Molina Healthcare Of Wi	$417 - $606	93%
Network Health Plan	$417 - $595	93%
UnitedHealthcare	$417 - $534	93%
Veteran'S Administration (Va Ccn)	$417	93%
Blue Cross Blue Shield	$429 - $528	95%
Group Health Cooperative Of Eau Claire	$442 - $677	98%
Icare	$446	99%
Wps Health Insurance	$480	106%
Cigna	$485 - $528	108%
Health Payment Systems	$496	110%
First Health	$606	134%
Trilogy	$642	142%
Healtheos By Multiplan Inc.	$663 - $677	147%
Health Partners	$677	150%
Coventry	$684	152%

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 $677.
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 - Beaver Dam (Mmc-Bd) 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.