Blood transfusion
Facility: Jewell County Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $689
- Cash Discount Price: $544
- vs. Medicare Baseline: 1.53x 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 |
|---|---|---|
| Rural Carriers - All Plans | $616 | 137% |
| Aetna | $652 | 145% |
| Meritain - All Plans | $652 | 145% |
| Midlands Choice - All Plans | $689 | 153% |
| Cigna | $689 | 153% |
| UnitedHealthcare | $689 | 153% |
| First Health - All Plans | $689 | 153% |
Consumer Guidance & Cost Commentary
For the CPT code 36430, representing a blood transfusion at Jewell County Hospital in Mankato, KS, the facility's cash median rate is $544.00, while the median amount paid by insurance is $689.00. This cash price is notably lower than the Medicare benchmark of $450.73, which serves as the federal baseline for evaluating hospital pricing markups. Although the cash rate exceeds the Medicare amount, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance negotiated rate exceeds this cash price, as the administrative overhead and contract dynamics often inflate commercial rates. It is important to note that while the facility is a Critical Access Hospital with government-local ownership, the specific county or state average for this procedure was not provided in the available data, so direct comparisons to regional averages cannot be made.
The data indicates that seven different payers, including Rural Carriers, Aetna, and UnitedHealthcare, have negotiated rates ranging from $616 to $689 for this service, with the median negotiated amount matching the median paid at $689.00. Because these commercial rates are significantly higher than the cash price, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, which can reduce the final bill by 20% to 50% by bypassing costly insurance claims processing. Additionally, since the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should verify their network status and request a waiver of insurance submission if they choose to pay cash upfront to avoid unexpected charges.