Blood transfusion
Facility: Grisell Memorial Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $83
- Cash Discount Price: $79
- vs. Medicare Baseline: 0.18x 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 | $62 - $83 | 14% |
| Medicaid / KanCare | $83 | 18% |
| Humana | $83 | 18% |
| Blue Cross Blue Shield | $485 | 108% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Grisell Memorial Hospital in Ransom, KS, the facility's negotiated rates with major payers like UnitedHealthcare, Medicaid/KanCare, and Humana are all set at $83.00, which matches the facility's median paid amount. This rate is significantly lower than the Medicare benchmark of $450.73, indicating a substantial discount from the federal government's cost-based standard. While the facility's cash price of $79.00 is slightly lower than the negotiated rate, patients with high-deductible plans might find paying the cash price more beneficial if their insurance allowed amount exceeds $79.00, as this avoids potential balance billing or unexpected out-of-pocket costs. It is important to note that while the No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, patients should still verify their specific plan details and ask the hospital directly about any "self-pay" or "prompt-pay" discounts that could further reduce the final bill.
The billing data for this service reflects a consistent pricing structure across four payers, with the highest negotiated rate being $485.00 for Blue Cross Blue Shield plans, which is notably higher than the $83.00 rates for other carriers. This variation highlights how different insurance contracts can lead to significantly different out-of-pocket costs, even for the same procedure at the same location. To ensure you are receiving the most accurate and transparent pricing, it is recommended to request a full itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors