Blood transfusion
Facility: Overland Park Reg Med Ctr
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $870
- Cash Discount Price: $2,402
- vs. Medicare Baseline: 1.93x 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 |
|---|---|---|
| Blue Cross Blue Shield | $186 - $2,067 | 41% |
| United | $257 - $2,163 | 57% |
| Amerigroup | $257 | 57% |
| Healthyblue | $263 | 58% |
| Medicaid / KanCare | $265 | 59% |
| Ambetter / Centene | $266 - $894 | 59% |
| Aetna | $268 - $4,111 | 59% |
| Unicare | $268 | 59% |
| Oscar | $271 - $913 | 60% |
| Wppa Providrs Care Network | $286 - $961 | 63% |
| Humana | $301 - $1,941 | 67% |
| Cigna | $354 - $3,513 | 79% |
| Home State Health Plan | $391 | 87% |
| Universal Healthcare | $500 - $1,995 | 111% |
| Coventry | $574 - $1,932 | 127% |
| Coventry Kc Mo | $585 - $1,971 | 130% |
| Multiplan | $600 - $3,557 | 133% |
| College Park Family Care Center | $614 - $2,067 | 136% |
| Corvel Corporation | $713 - $3,124 | 158% |
| Oha Network | $714 - $2,403 | 158% |
| Cco, Inc. | $1,071 - $3,605 | 238% |
| Focus Healthcare Mgmt, Inc | $1,071 - $3,605 | 238% |
| Triwest Health Alliance | $1,071 - $3,605 | 238% |
| Nhc Advantage | $2,550 | 566% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Overland Park Reg Med Ctr, the cash price is $2,402.00, which matches the facility's cash median. This rate is significantly higher than the state average, with a Medicare benchmark of $450.73 and a negotiated average of $870.00 across payers. While commercial insurance plans like Blue Cross Blue Shield and Aetna have negotiated rates ranging from $186 to $4,111, patients with high-deductible plans may find the cash price more affordable if their insurance allowed amount exceeds $2,402.00. It is important to note that while the facility offers a cash rate, patients should verify their specific plan's allowed amount before scheduling, as some in-network contracts may result in higher out-of-pocket costs than paying directly.
Patients should be aware of potential billing complexities, such as balance billing, where a provider bills the difference between the full chargemaster rate and the insurance allowed amount, though the No Surprises Act protects against this for emergency care at in-network facilities. Additionally, summary bills often obscure individual charges, so requesting a full itemized audit is crucial to identify errors or unbundled codes before payment. To minimize costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront, bypassing administrative fees and collection risks associated with insurance claims.