Blood transfusion
Facility: Kansas Medical Center Llc
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $366
- Cash Discount Price: $311
- vs. Medicare Baseline: 0.81x 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 |
|---|---|---|
| United | $128 | 28% |
| Wppa | $207 | 46% |
| Aetna | $233 | 52% |
| Medicaid / KanCare | $257 | 57% |
| Indian Health | $366 | 81% |
| Tricare | $366 | 81% |
| Medadv_Wellcare | $407 | 90% |
| Ambetter / Centene | $407 | 90% |
| Humana | $407 | 90% |
| Blue Cross Blue Shield | $407 - $493 | 90% |
| Three_Rivers | $813 | 180% |
Consumer Guidance & Cost Commentary
For this blood transfusion service at Kansas Medical Center Llc in Andover, the facility's cash price of $311.00 is significantly lower than the negotiated rates paid by most insurance payers, which range from $207 to $493. While the facility's negotiated rate of $366.00 is slightly higher than the cash price, it remains well below the gross chargemaster of $518.00. Patients with high-deductible plans or those who have not yet met their out-of-pocket maximums may find that paying the cash price directly is more cost-effective than relying on insurance, as the insurer's allowed amount often exceeds the cash rate. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting your deductible could result in higher out-of-pocket costs than paying cash outright.
To ensure you receive the most accurate billing, you should request a full itemized bill before paying, as summary invoices often hide unbundled charges or services not rendered. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is still advisable to dispute any unexpected charges in writing rather than accepting a summary bill immediately. Additionally, you can often reduce your final bill by asking for a prompt-pay discount, which typically offers a 20% to 50% reduction for upfront payment, bypassing the administrative costs associated with insurance claims processing.