CMS Price Transparency Data

Blood transfusion

Facility: Froedtert Community Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $484
Cash Discount Price: $532
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Froedtert Community Hospital is $484. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $532. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.07x the Medicare baseline. Located in 4805 S Moorland Rd, New Berlin, WI.

Cash / Self-Pay

$532

Average discount available for prompt cash payment at this facility.

Insurance Median

$484

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: $532 (118%)

Insurance Median: $484 (107%)

Cash: $532 (118% of Medicare)

Ins. Median: $484 (107% 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
Network Health Plan	$237 - $732	53%
UnitedHealthcare	$271 - $425	60%
Chorus Community Health Plan	$387	86%
Medical College Of Wisconsin	$387	86%
Centivo	$416 - $484	92%
Blue Cross Blue Shield	$425 - $435	94%
Care Wisconsin	$425	94%
Community Care	$425	94%
Health Partners	$425 - $629	94%
Humana	$425	94%
Icare	$425	94%
Molina	$425	94%
Security Health Plan Secure Savers	$425	94%
Cigna	$568	126%
Common Ground	$580	129%
Sheboygan Employers Health Network	$580	129%
Wisconsin Physician Services	$580	129%
Health Payment Systems	$591	131%
Trilogy	$629	140%
Americas Choice	$842	187%
Healtheos	$842	187%
Multiplan/Private Healthcare Systems	$842	187%
First Health Network	$851	189%

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 $532.
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 Froedtert Community Hospital 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.