CMS Price Transparency Data

Blood transfusion

Facility: Bellin Health Oconto Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,240
Cash Discount Price: $1,076
vs. Medicare Baseline: 2.75x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Bellin Health Oconto Hospital is $1,240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,076. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.75x the Medicare baseline. Located in 820 Arbutus Ave, Oconto, WI.

Cash / Self-Pay

$1,076

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,240

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: $1,076 (239%)

Insurance Median: $1,240 (275%)

Cash: $1,076 (239% of Medicare)

Ins. Median: $1,240 (275% 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 275% of the Medicare baseline (a markup of 175%). 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
Blue Cross Blue Shield	$563 - $1,278	125%
Community Care	$563	125%
Humana	$563	125%
My Choice	$563	125%
Network Health	$563 - $1,407	125%
UnitedHealthcare	$679 - $1,157	151%
Aetna	$828	184%
Cigna	$1,170 - $1,190	260%
Common Ground	$1,205 - $1,238	267%
Chorus Community Health Plan	$1,241	275%
Aspirus Arise	$1,296	288%
Healthsmart	$1,324	294%
Ihs(Claimsbridge)	$1,324	294%
Medical College Of Wi	$1,324	294%
Hps/Paymedix	$1,357 - $1,473	301%
Wps Insurance	$1,390	308%
Allied National	$1,407	312%
First Health	$1,407	312%
Galaxy Health	$1,407	312%
Three Rivers Provider Network	$1,490	331%
Trilogy	$1,490	331%

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 $1,076.
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 Bellin Health Oconto 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.