CMS Price Transparency Data

Blood transfusion

Facility: Gundersen Moundview Hospital and Clinics

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $771
Cash Discount Price: $644
vs. Medicare Baseline: 1.71x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Gundersen Moundview Hospital and Clinics is $771. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $644. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.71x the Medicare baseline. Located in 402 W Lake St, Friendship, WI.

Cash / Self-Pay

$644

Average discount available for prompt cash payment at this facility.

Insurance Median

$771

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: $644 (143%)

Insurance Median: $771 (171%)

Cash: $644 (143% of Medicare)

Ins. Median: $771 (171% 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
Amerigroup	$187	41%
Blue Cross Blue Shield	$402 - $1,341	89%
Health Partners	$402 - $1,467	89%
Security Health Plan	$402 - $764	89%
Ucare	$402 - $1,329	89%
Quartz	$477 - $905	106%
Wps	$675 - $1,280	150%
Wps - Arise	$675 - $1,280	150%
Dean Health Plan	$696 - $1,321	154%
Aspirus Arise Health	$726 - $1,379	161%
Humana	$744 - $1,412	165%
Multiplan/Healtheos	$770 - $1,595	171%
Coventry Health Care	$831 - $1,578	184%
Iowa Total Care	$1,341	298%
Managed Health Service	$1,341	298%

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 $644.
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 Gundersen Moundview Hospital and Clinics 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.