CMS Price Transparency Data

Blood transfusion

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $789
Cash Discount Price: $511
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Childrens Hospital of Wisconsin Fox Valley is $789. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $511. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.75x the Medicare baseline. Located in 130 Second St, Neenah, WI.

Cash / Self-Pay

$511

Average discount available for prompt cash payment at this facility.

Insurance Median

$789

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: $511 (113%)

Insurance Median: $789 (175%)

Cash: $511 (113% of Medicare)

Ins. Median: $789 (175% 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
Froedtert Health	$650 - $789	144%
Medical College Of Wisconsin	$650	144%
Network Health Plan	$661	147%
UnitedHealthcare	$683 - $3,990	152%
Aspirus Health Plan	$697	155%
Common Ground Healthcare Cooperative	$697 - $789	155%
Trilogy Health Solutions	$697 - $789	155%
Wps Health Plan	$706 - $836	157%
Advocate Aurora Healthcare	$715	159%
Blue Cross Blue Shield	$724 - $6,159	161%
Centivo	$724	161%
Health Partners	$724 - $817	161%
Employer Health Care Alliance Cooperative	$729	162%
Dean Health Plan	$743	165%
Group Health Cooperative Of Eau Claire	$743	165%
Oan Llc	$743	165%
Security Health Plan	$771	171%
Health Payment Systems	$786	174%
Praire States	$789	175%
Quartz Health Insurance	$789	175%
Sheboygan Employer'S Health Network	$789	175%
America'S Ppo	$808	179%
Aetna	$817 - $827	181%
Bellin Thedacare	$836	185%
Cigna	$836	185%
Group Health Cooperative Of South Central Wisconsin	$836	185%
Healthsmart	$836	185%
Prevea Health Network	$836	185%
Multiplan	$845 - $882	187%
Coventry Health Care	$882	196%

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 $511.
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 Childrens Hospital of Wisconsin Fox Valley 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.