Blood transfusion
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $568
- Cash Discount Price: $416
- vs. Medicare Baseline: 1.26x 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 |
|---|---|---|
| Lucent Health [6000] | $568 | 126% |
| Web Tpa [2115] | $568 | 126% |
| Hooray Health [8000] | $568 | 126% |
| Aetna | $568 | 126% |
| Healthcare Highways [2210] | $568 | 126% |
| Blue Cross Blue Shield | $568 | 126% |
| Oncology Patient Assistance Programs [2295] | $568 | 126% |
| Black Lung [6055] | $568 | 126% |
| Department Of Corrections [1340] | $692 | 154% |
| Cigna | $801 | 178% |
| American Postal Workers Union [1070] | $801 | 178% |
| Healthpartners [1500] | $801 | 178% |
| National Association Of Letter Carriers [1695] | $801 | 178% |
| Humana | $817 | 181% |
| 1199 Seiu Benefit Fund [3505] | $932 | 207% |
| First Health [1375] | $1,076 | 239% |
| Multiplan [1680] | $1,076 | 239% |
| Administrative Concepts [1005] | $1,076 | 239% |
| American Healthcare [1055] | $1,076 | 239% |
| Coventry Healthcare [1320] | $1,136 | 252% |
| Ks Disability Determination [6090] | $1,385 | 307% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at the University Of Kansas Health System - St Francis Campus in Topeka, KS, the facility's negotiated rates range from $568 to $1,385 depending on the payer, while the cash median price is significantly lower at $416. This cash rate is notably lower than the facility's negotiated amounts, which often exceed the cash price due to administrative costs and contract structures. Patients with high-deductible plans or those without insurance may find it financially advantageous to pay the cash median of $416 directly, as this bypasses the higher negotiated rates charged to commercial insurers. It is important to verify with the hospital's billing department for specific "self-pay" or "prompt-pay" discounts that could further reduce the final amount owed before scheduling any services.
When evaluating this charge, it is essential to compare the facility's pricing against objective benchmarks rather than the inflated chargemaster list price. The Medicare benchmark for this service is $450.73, which serves as a scientifically validated baseline for the true cost of delivery. The facility's cash rate of $416 is slightly below the Medicare amount, whereas the median negotiated rate of $568 represents a markup of approximately 26% over Medicare. Understanding this distinction helps consumers avoid the pitfalls of balance billing, where out-of-network providers might bill the full chargemaster rate, and ensures that patients are aware that commercial rates can vary widely even within the same network. Always request an itemized bill to confirm that no unbundled codes or services not rendered have inflated the total cost.