Blood transfusion
Facility: Rawlins County Health Center
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $888
- Cash Discount Price: $872
- vs. Medicare Baseline: 1.97x 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 |
|---|---|---|
| Blue Cross Blue Shield | $516 | 114% |
| UnitedHealthcare | $888 - $896 | 197% |
Consumer Guidance & Cost Commentary
For this blood transfusion procedure at Rawlins County Health Center in Atwood, KS, the cash median price is $872.00, which is lower than the facility's negotiated rate of $888.00. While the facility is in-network for UnitedHealthcare, the allowed amount for this service is $888.00, meaning patients with high-deductible plans might save money by paying the cash price directly, especially if their insurance does not cover the full negotiated amount. It is important to note that the facility's cash rate is significantly lower than the gross charge of $1,026.00, and patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling to ensure they receive the best possible upfront rate.
When comparing this service to federal benchmarks, the Medicare amount for this code is $450.73. The facility's cash price of $872.00 represents a markup of 2.0 times the Medicare rate, which is higher than the typical fair pricing range of 120% to 150% of Medicare. However, since the negotiated rate for UnitedHealthcare is $888.00, patients should verify their specific plan details to understand if their deductible has been met or if they would face balance billing if the insurance payment falls short of the allowed amount. Always request an itemized bill to confirm that no services were unbundled or double-charged before finalizing payment.