Blood transfusion
Facility: University Of Kansas Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $1,047
- Cash Discount Price: $508
- vs. Medicare Baseline: 2.32x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 232% of the Medicare baseline (a markup of 132%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Medica [503200074] | $176 | 39% |
| Workers Comp [503999901] | $176 - $2,414 | 39% |
| Geha [503200036] | $176 - $1,539 | 39% |
| UnitedHealthcare | $176 - $659 | 39% |
| Ku Athletics [503200094] | $412 | 91% |
| Lasso Healthcare [503999926] | $412 | 91% |
| Devoted [503200068] | $412 | 91% |
| Triwest [503201703] | $412 | 91% |
| Tricare | $412 | 91% |
| Medicare (plans) | $412 - $420 | 91% |
| Humana | $412 - $420 | 91% |
| Aetna | $412 - $1,719 | 91% |
| Allwell [503200078] | $424 | 94% |
| Blue Cross Blue Shield | $424 - $1,950 | 94% |
| American Health Plans [503200968] | $432 | 96% |
| Centurion [5032000966] | $535 | 119% |
| Ambetter / Centene | $700 | 155% |
| Gallagher Bassett [5032000103] | $750 | 166% |
| Larned State Hospital [503200090] | $750 | 166% |
| Sedgwick Claims Management Services [53201618] | $750 | 166% |
| Alt Bnsf Railway Co [503301503] | $750 | 166% |
| Prime Health Services [503999912] | $750 | 166% |
| Hchsync Centrus Health Direct [503999916] | $762 - $889 | 169% |
| Wellfit [503301514] | $783 | 174% |
| Oscar [503201609] | $783 | 174% |
| Centivo [5032000982] | $783 | 174% |
| 6 Degrees Health [503999050] | $803 - $1,030 | 178% |
| Alt Wppa [5032000964] | $824 - $1,539 | 183% |
| Occunet [503999930] | $865 | 192% |
| Fort Hays State Student Athletes [5032000960] | $865 | 192% |
| Alt Theramatrix [5032000967] | $1,047 | 232% |
| Multiplan [503200057] | $1,112 | 247% |
| Claimdoc [503301509] | $1,112 | 247% |
| Health Plan Inc [503999941] | $1,194 | 265% |
| Advanced Medical Pricing Solutions [503301513] | $1,236 | 274% |
| Cigna | $1,262 - $2,033 | 280% |
| Accarent Health [503999034] | $1,270 | 282% |
| Alt Carelon Behavioral Health [503200905] | $1,270 | 282% |
| Coventry [503200022] | $1,311 - $1,719 | 291% |
| Coresource [503200089] | $1,311 | 291% |
| Meritain Health [503200039] | $1,311 - $2,134 | 291% |
| National Assn Letter Carriers [503200019] | $1,403 | 311% |
| Allied National [503999937] | $1,525 | 338% |
| Php [503200005] | $1,525 - $1,878 | 338% |
| Med-Pay [503200040] | $1,539 | 341% |
| Healthlink [503200007] | $1,539 - $1,878 | 341% |
| Cerner [503200038] | $1,539 | 341% |
| Inter-Americas Insurance [503999032] | $1,539 | 341% |
| First Health [5032000110] | $1,675 | 372% |
| Aha-Healthcare Preferred [503200050] | $1,675 | 372% |
| Alt Meritain Health [503999911] | $1,719 | 381% |
| Consolidated Billing [50311256] | $1,779 | 395% |
| Correct Care Solutions [50311253] | $1,779 | 395% |
| Ascension Living Hope [503201517] | $1,779 | 395% |
| Coeur Plan Services [503301517] | $1,779 | 395% |
| Orscheln Industries [503201608] | $1,906 | 423% |
| Empire Plan/Nyship [503200705] | $1,950 | 433% |
| Alt Lineco [5032000976] | $1,950 | 433% |
| Alt Lucent Health Solutions [503202603] | $1,950 | 433% |
| Point Comfort Underwriters [503200018] | $2,033 | 451% |
| Quiktrip [5032000412] | $2,033 | 451% |
| Century Health Solutions [503200054] | $2,033 | 451% |
| Wppa [503200056] | $2,134 | 473% |
| Usa Managed Care [503999030] | $2,287 | 507% |
| Employers Health Network [503999025] | $2,287 | 507% |
| Three Rivers Provider Network [503999029] | $2,287 | 507% |
| Plan Care America [503999026] | $2,287 | 507% |
| Sanford Health Plan [503999027] | $2,287 | 507% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at University Of Kansas Hospital, the facility's cash price of $508.00 is significantly lower than the gross charge of $2,541.00 and the median negotiated rate of $1,047.00. While the facility's cash rate is higher than the national cash median of $508.00, it remains substantially below the highest negotiated rates observed among payers, which can reach up to $2,287.00. Patients with high-deductible plans or those without insurance may find the cash price advantageous, as paying directly can sometimes result in lower out-of-pocket costs compared to insurance claims where the negotiated rate exceeds the cash price. It is important to note that the facility's cash rate is also higher than the Medicare benchmark of $450.73, which serves as a baseline for the true cost of care, suggesting that commercial rates often include administrative markups.
The facility's pricing structure reflects a wide variance across different payer contracts, with negotiated rates ranging from a low of $176.00 to a high of $2,287.00 depending on the insurance carrier. This disparity highlights the importance of verifying specific allowed amounts before scheduling services, as in-network status does not guarantee the lowest possible price. Consumers should be aware that hospitals often issue summary bills that obscure individual line items, making it difficult to identify errors or unbundled charges; requesting a full itemized bill is a critical step in ensuring accuracy and reducing potential medical debt. Additionally, patients should inquire about prompt-pay discounts, which can offer a fee reduction of