Blood transfusion
Facility: Wichita County Health Center
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $546
- Cash Discount Price: $530
- vs. Medicare Baseline: 1.21x 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 |
|---|---|---|
| Medicaid / KanCare | $72 - $563 | 16% |
| UnitedHealthcare | $87 - $682 | 19% |
Consumer Guidance & Cost Commentary
For the Blood transfusion procedure (CPT 36430) at Wichita County Health Center in Leoti, KS, the facility's cash median rate of $530.00 is lower than the state average of $546.00, making it a potentially cost-effective option for self-pay patients. While the facility's negotiated rates with major payers like Medicaid/KanCare and UnitedHealthcare range from $72 to $682, these amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans or those without insurance may find paying the cash median of $530.00 directly more affordable than relying on insurance, which could result in higher out-of-pocket costs if the negotiated allowed amount surpasses the cash rate.
To ensure you are not overcharged, it is critical to request a full itemized bill before finalizing payment, as summary bills often obscure individual line items and potential errors. If you receive a balance bill for the difference between the provider's full charge and your insurance payment, you may be protected under the No Surprises Act, which bans such billing for emergency care and non-emergency services at in-network facilities. Additionally, you should explicitly ask the billing department about prompt-pay discounts, which can reduce the total amount owed by 20% to 50% if you settle the account upfront, effectively bypassing the costly claims processing cycle that inflates commercial rates.