CMS Price Transparency Data

Blood transfusion

Facility: Black River Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $474
Cash Discount Price: $587
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Black River Memorial Hospital is $474. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $587. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.05x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$587

Average discount available for prompt cash payment at this facility.

Insurance Median

$474

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: $587 (130%)

Insurance Median: $474 (105%)

Cash: $587 (130% of Medicare)

Ins. Median: $474 (105% 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
Blue Cross Blue Shield	$83 - $1,168	18%
Humana	$83 - $1,234	18%
My Choice Wisconsin, Inc.	$83 - $677	18%
Quartz Health Solutions, Inc	$83 - $1,208	18%
Security Health Plan	$83 - $1,239	18%
UnitedHealthcare	$83 - $1,251	18%
Corvel	$99 - $809	22%
The Alliance	$138 - $1,274	31%
Triology Health Solutions	$146 - $1,261	32%
Medica	$151 - $1,239	34%
Association Benefits Solution	$154 - $1,261	34%
Family Health Center Of Marshfield	$154 - $1,261	34%
First Health Group Corporation	$154 - $1,261	34%
Provider Network Of America	$154 - $1,261	34%
Cigna	$157 - $1,287	35%
Cofinity	$157 - $1,287	35%
Coventry Health Care	$157 - $1,287	35%
Custom Benefit Administrators	$157 - $1,287	35%
Group Health Cooperative Of Eau Claire	$157 - $1,287	35%
Healthpartners, Inc.	$157 - $1,287	35%
Multiplan	$157 - $1,314	35%
Wisconsin Physicians Service Insurance Corp	$157 - $1,287	35%
Chorus	$159 - $1,300	35%

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 $587.
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 Black River Memorial 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.