Blood transfusion
Facility: Lane County Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $315
- Cash Discount Price: $300
- vs. Medicare Baseline: 0.70x 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 |
|---|---|---|
| Aetna | $225 - $332 | 50% |
| UnitedHealthcare | $225 - $350 | 50% |
| Healthy Blue Mcr Adv - All Other Plans | $250 - $350 | 55% |
| Medicaid / KanCare | $250 - $385 | 55% |
| Healthy Blue Mcaid | $250 - $350 | 55% |
| Wppa Providers-All Plans | $375 - $525 | 83% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Lane County Hospital in Dighton, KS, the cash price is $300.00, which matches the facility's median negotiated rate of $315.00 and the state average of $300.00. While commercial payers like Aetna and UnitedHealthcare have negotiated rates ranging from $225 to $385 depending on the specific plan, the cash price remains competitive and aligns with the state average. It is important to note that for patients with high-deductible plans, paying the cash price of $300.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates for some commercial plans exceed the cash price. Additionally, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
This service is provided by a Critical Access Hospital with government ownership, and the facility's pricing is benchmarked against the Medicare rate of $450.73. The cash price of $300.00 represents 67% of the Medicare amount, indicating a significant discount compared to the federal baseline. When reviewing your bill, remember that hospitals often issue summary bills that obscure individual charges; always request a full itemized statement to identify any errors, unbundled codes, or services not rendered. Furthermore, if you receive a balance bill for out-of-network ancillary services, you may be eligible for protections under the No Surprises Act, which prevents providers from charging you the difference between their full rate and your insurance's allowed amount for emergency or non-emergency