CMS Price Transparency Data

Blood transfusion

Facility: Upland Hills Health

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $677
Cash Discount Price: $551
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Upland Hills Health is $677. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $551. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.50x the Medicare baseline. Located in 800 Compassion Way, Dodgeville, WI.

Cash / Self-Pay

$551

Average discount available for prompt cash payment at this facility.

Insurance Median

$677

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: $551 (122%)

Insurance Median: $677 (150%)

Cash: $551 (122% of Medicare)

Ins. Median: $677 (150% 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
UnitedHealthcare	$39 - $66	9%
Blue Cross Blue Shield	$254 - $1,342	56%
Humana	$254 - $1,473	56%
Icare	$254 - $458	56%
Medical Associates	$254 - $1,227	56%
Mhs	$254 - $613	56%
Security Health Plan	$254 - $458	56%
Alliance	$513 - $925	114%
Wps	$554 - $1,029	123%
Ghc Of Eau Claire	$613	136%
Ghc Of Sc Wi	$613 - $1,113	136%
Quartz	$626 - $1,129	139%
Dean Health Plan	$631 - $1,138	140%
Cigna	$677 - $1,365	150%
Multiplan	$799 - $1,440	177%

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 $551.
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 Upland Hills Health 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.