CMS Price Transparency Data

Blood transfusion

Facility: Columbus Community Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,291
Cash Discount Price: $1,201
vs. Medicare Baseline: 2.86x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Columbus Community Hospital is $1,291. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,201. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.86x the Medicare baseline. Located in 1515 Park Ave, Columbus, WI.

Cash / Self-Pay

$1,201

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,291

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: $1,201 (266%)

Insurance Median: $1,291 (286%)

Cash: $1,201 (266% of Medicare)

Ins. Median: $1,291 (286% 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 286% of the Medicare baseline (a markup of 186%). 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
Alliance	$414	92%
Icare	$420 - $798	93%
Dean Health Plan	$451 - $5,149	100%
My Choice Wisconsin	$451 - $798	100%
Quartz	$451 - $1,648	100%
Security Health Plan	$451 - $1,872	100%
UnitedHealthcare	$451 - $2,082	100%
Blue Cross Blue Shield	$798 - $1,931	177%
Cigna	$867 - $1,500	192%
Health Payment Systems	$1,088 - $1,881	241%
Trilogy	$1,189 - $2,057	264%
Wps	$1,221 - $2,112	271%
Healtheos	$1,262 - $2,332	280%
First Health	$1,276 - $2,207	283%
Humana	$1,305 - $2,257	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 $1,201.
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 Columbus 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.