Blood transfusion
Facility: Kansas Heart Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $407
- Cash Discount Price: $511
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| UnitedHealthcare | $120 - $811 | 27% |
| Wppa - All Plans | $324 | 72% |
| Tricare | $366 | 81% |
| Blue Cross Blue Shield | $387 - $811 | 86% |
| Medicaid / KanCare | $407 - $811 | 90% |
| Humana | $407 | 90% |
| Celtic Mcr Adv | $407 | 90% |
| Multiplan - All Plans | $730 | 162% |
| Aetna | $790 - $811 | 175% |
| Soonerselect Mcaid - All Plans | $811 | 180% |
| Celtic Mcaid - All Other Plans | $811 | 180% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Kansas Heart Hospital in Wichita, KS, the facility's cash price is $511.00, which is lower than the state average of $527.00. While the hospital's gross charge is $811.00, in-network insurance plans such as UnitedHealthcare and Blue Cross Blue Shield may negotiate rates ranging from $324 to $811, meaning the negotiated amount could exceed the cash price. Patients with high-deductible plans should consider paying the cash price of $511.00 directly, as this avoids potential out-of-pocket costs that could reach the higher negotiated rates if their insurance has not yet met its deductible. It is also recommended to ask the billing department about self-pay or prompt-pay discounts, which can further reduce the final amount owed.
The facility's negotiated rate of $407.00 is lower than the gross charge but still higher than the cash price, illustrating how administrative costs and insurance processing fees can inflate the baseline price. Since Medicare rates for this service are $450.73, the cash price of $511.00 represents a reasonable benchmark compared to the federal standard, though it is slightly above the Medicare amount. If a patient receives care from an out-of-network provider or encounters unexpected ancillary services, they may face balance billing for the difference between the provider's full charge and the insurance allowed amount. To avoid surprise bills, patients should request an itemized audit of their statement to identify any unbundled codes or services not rendered, and they should dispute any balance bills immediately rather than accepting summary invoices or signing