Blood transfusion
Facility: Via Christi Hospital Wichita St Teresa, Inc
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $408
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.91x 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 |
|---|---|---|
| Vc Hope | $404 | 90% |
| Humana | $404 | 90% |
| Saint Lukes Health Systems | $404 | 90% |
| Medicare (plans) | $404 - $412 | 90% |
| Via Christi Research | $404 | 90% |
| Va | $404 | 90% |
| Blue Cross Blue Shield | $412 | 91% |
| UnitedHealthcare | $412 - $1,132 | 91% |
| Corizon | $505 | 112% |
| Smarthealth | $566 | 126% |
| Medicaid / KanCare | $687 | 152% |
Consumer Guidance & Cost Commentary
For the procedure code 36430 (Blood transfusion) at Via Christi Hospital Wichita St Teresa, Inc, the negotiated rates vary significantly depending on your insurance plan. While most major payers like Vc Hope, Humana, and Saint Lukes Health Systems have a consistent negotiated rate of $404, UnitedHealthcare offers a range from $412 to $1,132, and Blue Cross Blue Shield sets a rate of $412. It is important to note that the median negotiated rate across all payers is $408.00, which is slightly higher than the Medicare benchmark of $450.73. This comparison highlights that while commercial rates are often inflated by administrative overhead and contract dynamics, the facility's negotiated prices remain relatively close to the federal baseline for this specific service.
For patients without insurance or with high-deductible plans, the cash price may offer a more affordable option, as prompt-pay discounts can reduce the total cost by 20% to 50%. Since the data indicates the cash median is not explicitly listed, it is crucial to contact the hospital directly before scheduling to confirm their "self-pay" or "prompt-pay" rates and request a waiver of insurance submission to avoid automatic claims processing. Additionally, because this facility is an in-network location for most major carriers, the No Surprises Act protects patients from balance billing for out-of-network services, ensuring that any unexpected charges are limited to the agreed-upon negotiated amounts or the cash rate if you choose to pay upfront.