Blood transfusion
Facility: Centura St. Catherine-Dodge City
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $1,384
- Cash Discount Price: $841
- vs. Medicare Baseline: 3.07x 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 307% of the Medicare baseline (a markup of 207%). 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 |
|---|---|---|
| Cigna | $37 | 8% |
| Humana | $37 | 8% |
| Kaiser | $37 | 8% |
| Kansas Health | $37 | 8% |
| Blue Cross Blue Shield | $37 - $606 | 8% |
| Aetna | $37 - $1,682 | 8% |
| Medicare (plans) | $37 | 8% |
| Centura Employee Plan | $736 | 163% |
| UnitedHealthcare | $1,384 | 307% |
| Wpaa | $1,472 | 327% |
| Christian Health Aid | $1,682 | 373% |
| Multiplan | $1,682 - $1,893 | 373% |
| Health Partners Of Kansas | $1,893 | 420% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Centura St. Catherine-Dodge City in Dodge City, KS, the facility's cash median price is $841.00, which is significantly lower than the state average of $1,178.00. While commercial payers like Aetna and Multiplan negotiate rates as high as $1,682 and $1,893 respectively, the cash price remains the most transparent benchmark for patients. It is important to note that cash-pay options can sometimes be more cost-effective for individuals with high-deductible plans if their insurance negotiated rates exceed the cash price, though patients should always verify their specific plan coverage before deciding. Additionally, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When evaluating the cost of this procedure, it is crucial to compare rates against the Medicare benchmark rather than the hospital's gross chargemaster. The Medicare amount for this service is $450.73, and the facility's cash rate of $841.00 represents a markup of approximately 3.1 times the Medicare rate. While commercial negotiated rates often average between 200% and 300% of Medicare, the cash price here aligns more closely with fair pricing standards. To ensure accuracy, consumers should request a full itemized bill to review specific CPT codes and avoid paying for unbundled services or items not rendered, as summary bills often obscure these details.