Blood transfusion
Facility: Saint John Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $420
- Cash Discount Price: $415
- vs. Medicare Baseline: 0.93x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Comp Alliance Workers Comp | $69 | 15% |
| Medicaid / KanCare | $257 | 57% |
| UnitedHealthcare | $257 - $582 | 57% |
| Celtic | $263 - $665 | 58% |
| Healthy Blue | $263 - $436 | 58% |
| Cigna | $416 | 92% |
| Tricare | $416 | 92% |
| Midland Care Connection | $416 | 92% |
| Aetna | $416 - $1,662 | 92% |
| Medicare (plans) | $416 | 92% |
| Kansas Superior Select | $424 | 94% |
| Well Path | $582 | 129% |
| Employer Direct Healthcare | $582 | 129% |
| Corizon | $582 | 129% |
| Centurion | $623 | 138% |
| Naphcare | $644 | 143% |
| Oha Networks | $728 | 162% |
| Worker Compensation | $750 | 166% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Saint John Hospital in Leavenworth, KS, the facility's cash median rate is $415.00, which is significantly lower than the negotiated rates paid by most insurance plans. While the facility's cash price is well below the gross charge of $2,524.00, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance negotiated rate exceeds this amount. The data shows that while some payers like Comp Alliance Workers Comp and Medicaid/KanCare have a single plan rate of $69 and $257 respectively, many commercial payers including Aetna and Celtic have negotiated ranges extending up to $1,662 and $665. Because commercial rates often include administrative overhead and contract markups, the cash price serves as a strong baseline for comparison, though patients should verify if their specific plan has a lower allowed amount before scheduling.
To minimize unexpected costs, patients should proactively request a "self-pay" or "prompt-pay" discount from the hospital before receiving care, as these upfront payments can bypass the costly insurance claims process and administrative fees. It is also critical to demand a full itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered that can inflate the final charge. When evaluating the facility's pricing, it is important to compare rates against the Medicare benchmark of $450.73 rather than the inflated chargemaster list; the facility's cash rate of $415.00 is actually slightly below the Medicare amount, suggesting