CMS Price Transparency Data

Blood transfusion

Facility: Aurora Medical Center Bay Area

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,221
Cash Discount Price: $725
vs. Medicare Baseline: 2.71x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Aurora Medical Center Bay Area is $1,221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $725. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.71x the Medicare baseline. Located in 3003 University Dr, Marinette, WI.

Cash / Self-Pay

$725

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,221

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: $725 (161%)

Insurance Median: $1,221 (271%)

Cash: $725 (161% of Medicare)

Ins. Median: $1,221 (271% 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 271% of the Medicare baseline (a markup of 171%). 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
Everpointe Elite	$725 - $1,291	161%
Hs Technology	$725 - $2,138	161%
Aetna	$774 - $1,894	172%
Quartz One	$798 - $1,670	177%
Blue Cross Blue Shield	$841 - $3,111	187%
Aurora Caregiver	$870 - $1,300	193%
Common Ground	$870 - $1,492	193%
Health Eos Plus	$870	193%
Healthpartners	$870 - $1,088	193%
Molina Exchange	$870 - $1,825	193%
Quartz Group	$870 - $1,950	193%
Wisconsin Physician Service	$899 - $2,226	199%
Health Payment Systems	$942 - $2,300	209%
Trilogy	$1,015 - $2,340	225%
Centivo	$1,088 - $1,967	241%
Cigna	$1,088 - $3,500	241%
Health Eos	$1,160	257%
UnitedHealthcare	$1,221 - $1,789	271%

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 $725.
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 Aurora Medical Center Bay Area 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.