Blood transfusion
Facility: Ellinwood District Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $350
- Cash Discount Price: $425
- vs. Medicare Baseline: 0.78x 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 | $56 - $490 | 12% |
| Aetna | $56 - $490 | 12% |
| Humana | $56 - $490 | 12% |
| Cigna | $56 - $490 | 12% |
| Blue Cross Blue Shield | $56 - $490 | 12% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Ellinwood District Hospital in Ellinwood, KS, the cash median price is $425.00, which is lower than the negotiated rates paid by major insurers like UnitedHealthcare, Aetna, Humana, Cigna, and Blue Cross Blue Shield. These five payers have a low-end negotiated rate of $56 and a high-end rate of $490 across their 11 plans each. Because commercial insurance contracts often include administrative overhead and risk adjustments, the negotiated amount can exceed the cash price, making self-pay a potentially more affordable option for patients with high-deductible plans who have not yet met their coverage thresholds.
The facility's cash rate of $425.00 is also lower than the Medicare benchmark of $450.73, which serves as a scientifically validated baseline for the true cost of care. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can further reduce costs. If you receive a bill that includes charges for services not rendered or unbundled components, you should request a full itemized audit to ensure accuracy, as over 80% of hospital bills contain errors that can be corrected through formal written disputes.