CMS Price Transparency Data

Blood transfusion

Facility: Aurora Psychiatric Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,789
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3.97x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Aurora Psychiatric Hospital is $1,789. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.97x the Medicare baseline. Located in 1220 Dewey Ave, Wauwatosa, WI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,789

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%)

Insurance Median: $1,789 (397%)

Ins. Median: $1,789 (397% 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 397% of the Medicare baseline (a markup of 297%). 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
Everpointe Elite	$1,291	286%
Aurora Caregiver	$1,300	288%
Blue Cross Blue Shield	$1,377 - $1,530	306%
Common Ground	$1,492	331%
UnitedHealthcare	$1,630 - $1,789	362%
Quartz One	$1,670	371%
Molina Exchange	$1,825	405%
Aetna	$1,894	420%
Quartz Group	$1,950	433%
Centivo	$1,967	436%
Wisconsin Physician Service	$2,115 - $2,226	469%
Hs Technology	$2,138	474%
Health Payment Systems	$2,300	510%
Trilogy	$2,340	519%
Cigna	$3,500	777%

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 $X.
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 Aurora Psychiatric 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.