Blood transfusion
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $404
- Cash Discount Price: $485
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| Providrs Care | $44 | 10% |
| UnitedHealthcare | $225 - $1,132 | 50% |
| Aetna | $234 | 52% |
| Medicaid / KanCare | $234 - $236 | 52% |
| Tricare | $260 | 58% |
| Va | $404 | 90% |
| Medicare (plans) | $404 - $412 | 90% |
| Humana | $404 - $408 | 90% |
| Blue Cross Blue Shield | $558 - $588 | 124% |
| Smarthealth | $566 | 126% |
| Ambetter / Centene | $687 | 152% |
| Medica | $1,000 | 222% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Ascension Via Christi Hospital Manhattan, Inc, the facility's cash median price is $485.00, which is lower than the negotiated rates paid by most major payers listed in this report. While the facility's cash rate is higher than the state of Kansas average for this service, it remains significantly below the contracted amounts for insurers such as UnitedHealthcare (ranging from $225 to $1,132) and Blue Cross Blue Shield ($558 to $588). Patients with high-deductible plans may find the cash price more affordable than their insurance allowed amount, provided they can secure a self-pay or prompt-pay discount before treatment. It is important to note that while the facility offers a cash rate, commercial insurance contracts often set a ceiling that prevents patients from paying the full chargemaster gross of $1,212.00, though these negotiated rates can still exceed the cash option for some policies.
To minimize unexpected costs, consumers should request an itemized billing audit to ensure no unbundled codes or services not rendered are included in the final invoice, as over 80% of hospital bills contain errors. Additionally, patients should verify their deductible status before scheduling, as paying the negotiated rate without meeting the deductible could result in out-of-pocket expenses exceeding the cash price. Although the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, it is crucial to refuse signing any waivers that might waive these protections for emergency or mandatory ancillary services. Finally, patients should contact the hospital directly to confirm the availability of prompt-pay discounts, which can