CMS Price Transparency Data

Blood transfusion

Facility: Crossing Rivers Health Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,228
Cash Discount Price: $1,293
vs. Medicare Baseline: 2.72x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Crossing Rivers Health Medical Center is $1,228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,293. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.72x the Medicare baseline. Located in 37868 Us Hwy 18, Prairie Du Chien, WI.

Cash / Self-Pay

$1,293

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,228

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: $1,293 (287%)

Insurance Median: $1,228 (272%)

Cash: $1,293 (287% of Medicare)

Ins. Median: $1,228 (272% 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 272% of the Medicare baseline (a markup of 172%). 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
Amerigroup Mcr Adv	$543	120%
Blue Cross Blue Shield	$543 - $1,254	120%
UnitedHealthcare	$543	120%
Humana	$548 - $1,295	122%
Security Hlth Mcr Adv	$566	126%
Amerigroup Mcaid-All Other Plans	$978	217%
Iowa Total Care Mcaid-All Plans	$978	217%
Quartz - All Plans	$1,034	229%
Dean Health Plan - All Plans	$1,228	272%
Medica Comm - All Other Plans	$1,228	272%
Medica Hp Solutions	$1,228	272%
Security Hlth Comm - All Other Plans	$1,228	272%
Health Trad Hp - All Plans	$1,241	275%
Wea Provider Ntwrk - All Plans	$1,241	275%
First Health - All Plans	$1,254	278%
Geha - All Plans	$1,254	278%
Health Partners - All Plans	$1,254	278%
Cigna	$1,308	290%
Group Health Co-Op - All Plans	$1,308	290%
Medical Associates Hp - All Plans	$1,308	290%
Preferred Health Choice - All Plans	$1,308	290%
Wps - All Plans	$1,308	290%

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 $1,293.
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 Crossing Rivers Health 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.