Blood transfusion
Facility: Providence Medical Center
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $436
- Cash Discount Price: $415
- vs. Medicare Baseline: 0.97x 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 - Fka Compresults Worker Compensation | $69 | 15% |
| Medicaid / KanCare | $257 | 57% |
| UnitedHealthcare | $257 - $624 | 57% |
| Celtic | $263 - $665 | 58% |
| Healthy Blue | $263 - $436 | 58% |
| Aetna | $300 - $1,662 | 67% |
| Cigna | $416 | 92% |
| Tricare | $416 | 92% |
| Midland Care Connection | $416 | 92% |
| Medicare (plans) | $416 | 92% |
| Kansas Superior Select | $436 | 97% |
| Corizon | $540 | 120% |
| Employer Direct Healthcare | $582 | 129% |
| Well Path Prison | $582 | 129% |
| Centurion | $623 | 138% |
| Naphcare | $644 | 143% |
| Blue Cross Blue Shield | $665 - $769 | 148% |
| Oha Networks | $728 | 162% |
| Worker Compensation | $750 | 166% |
Consumer Guidance & Cost Commentary
For this blood transfusion service at Providence Medical Center in Kansas City, KS, the facility's cash median rate of $415.00 is significantly lower than the negotiated rates charged to most insurance payers, which range from $257 to $1,662. While the facility's cash price is also lower than the state average for this procedure, patients with high-deductible plans or those without insurance may find paying out-of-pocket the most cost-effective option, as the cash rate avoids the administrative markup inherent in insurance billing. It is important to note that while the facility is a voluntary non-profit church-owned acute care hospital, the negotiated rates for in-network plans often exceed the cash price due to the costs of claims processing and contract management.
Patients should be aware that insurance companies negotiate maximum rates for this service, which can result in higher bills than the cash price even for in-network coverage. If you have insurance, you should verify your specific plan's allowed amount before scheduling, as some payers like UnitedHealthcare and Aetna have negotiated ranges that extend well beyond the cash rate. Additionally, if you choose to pay directly, ask the hospital about "prompt-pay" discounts, which can further reduce the final cost by paying in full upfront. Always request an itemized bill to ensure accuracy, as summary bills may obscure individual charges, and remember that federal protections like the No Surprises Act may prevent balance billing for out-of-network services in certain emergency or non-emergency scenarios.