Blood transfusion
Facility: Saint Luke'S South Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $861
- Cash Discount Price: $3,603
- vs. Medicare Baseline: 1.91x 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 |
|---|---|---|
| Medicaid / KanCare | $257 - $559 | 57% |
| UnitedHealthcare | $265 - $488 | 59% |
| Humana | $648 - $1,324 | 144% |
| Cigna | $652 - $1,537 | 145% |
| Transplants-Case Rates [5750] | $709 - $2,025 | 157% |
| Blue Cross Blue Shield | $911 - $1,521 | 202% |
| Aetna | $1,108 - $1,924 | 246% |
| Commercial-Contracted [8000] | $1,199 - $1,638 | 266% |
| First Health [5512] | $1,200 | 266% |
Consumer Guidance & Cost Commentary
For the blood transfusion procedure (CPT 36430) at Saint Luke's South Hospital in Overland Park, Kansas, the cash median price is $3,603, which is significantly lower than the facility's gross charge of $6,005. This cash rate is notably lower than the state average for this service, making it an attractive option for patients with high-deductible plans or those without insurance. While commercial payers like UnitedHealthcare and Humana negotiate rates ranging from $265 to $1,537, these amounts often exceed the cash price due to administrative costs and contract structures. Patients should verify their specific plan's deductible status before scheduling, as paying the cash rate upfront can sometimes result in immediate savings compared to the allowed amount their insurer would pay, provided they can afford the difference.
To ensure you are not overcharged, it is crucial to request an itemized bill before finalizing payment, as summary bills often obscure individual line items and potential errors. If you receive a bill for the difference between your insurance payment and the full charge, you may be facing balance billing, though the No Surprises Act protects you from such unexpected costs for emergency care and non-emergency services at in-network facilities. Additionally, ask the hospital about prompt-pay discounts, which can reduce the cash price by 20% to 50% if paid in full within 30 days, effectively bypassing the administrative fees associated with insurance claims. Always dispute any discrepancies in writing and avoid signing consent waivers that waive your rights to review out-of-network costs for ancillary services.