Blood transfusion
Facility: Menorah Medical Center
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $918
- Cash Discount Price: $2,669
- vs. Medicare Baseline: 2.04x 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 204% of the Medicare baseline (a markup of 104%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $56 - $1,815 | 12% |
| Ambetter / Centene | $81 - $750 | 18% |
| Oscar | $83 - $766 | 18% |
| Wppa Providrs Care Network | $87 - $807 | 19% |
| Humana | $92 - $1,941 | 20% |
| Cigna | $108 - $3,513 | 24% |
| United | $109 - $1,815 | 24% |
| Aetna | $113 - $4,111 | 25% |
| Universal Healthcare | $152 - $1,995 | 34% |
| Coventry | $175 - $1,621 | 39% |
| Coventry Kc Mo | $178 - $1,654 | 39% |
| College Park Family Care Center | $187 - $1,734 | 41% |
| Oha Network | $217 - $2,017 | 48% |
| Amerigroup | $257 | 57% |
| Healthyblue | $263 | 58% |
| Medicaid / KanCare | $265 | 59% |
| Unicare | $268 | 59% |
| Corvel Corporation | $282 - $2,622 | 63% |
| Multiplan | $321 - $2,985 | 71% |
| Triwest Health Alliance | $326 - $3,025 | 72% |
| Cco, Inc. | $326 - $3,025 | 72% |
| Focus Healthcare Mgmt, Inc | $326 - $3,025 | 72% |
| Home State Health Plan | $391 | 87% |
| Nhc Advantage | $2,550 | 566% |
Consumer Guidance & Cost Commentary
For this blood transfusion service at Menorah Medical Center in Overland Park, KS, the cash price is $2,669.00, which matches the facility's cash median. While the facility's negotiated rates with major payers like Aetna and Cigna range from $1,130 to over $4,000, the cash price is notably lower than the gross charges but comparable to the state average for this procedure. Patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance negotiated rates, which can sometimes exceed the cash amount due to administrative costs and contract structures. It is important to verify if your specific plan has a lower allowed amount than the cash price before scheduling, as paying out-of-pocket might result in a lower total cost.
To ensure you are not overcharged, always request an itemized bill that lists every specific CPT code and unit cost, as summary bills often hide unbundled charges or services not rendered. If you receive a balance bill for the difference between the provider's full charge and your insurance payment, remember that the No Surprises Act generally protects you from these unexpected bills for emergency care and non-emergency services at in-network facilities. Additionally, ask the hospital about prompt-pay discounts, which can reduce the final amount by 20% to 50% if you pay in full upfront, bypassing the lengthy insurance claims process and potential administrative fees.