Blood transfusion
Facility: Cheyenne County Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $502
- Cash Discount Price: $485
- vs. Medicare Baseline: 1.11x 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 |
|---|---|---|
| First Health - All Plans | $25 - $642 | 6% |
| Aetna | $26 - $872 | 6% |
| Healthy Blue Mcr Adv | $26 - $661 | 6% |
| Tricare | $26 - $661 | 6% |
| UnitedHealthcare | $26 - $918 | 6% |
| Choice Care - All Plans | $26 - $667 | 6% |
| Firstguard - All Plans | $29 - $734 | 6% |
| Wppa - All Plans | $32 - $826 | 7% |
| Cpm - All Plans | $34 - $872 | 8% |
| Preferred Hc - All Plans | $34 - $872 | 8% |
| Midlands Choice - All Plans | $35 - $890 | 8% |
| Unicare - All Plans | $35 - $899 | 8% |
| Ppo Next - All Plans | $35 - $899 | 8% |
| Integrated Hp - All Plans | $35 - $899 | 8% |
| Health Partners - All Plans | $35 - $899 | 8% |
| Healthy Blue Mcaid - All Other Plans | $36 - $918 | 8% |
| Childrens Mercy - All Plans | $36 - $918 | 8% |
| Healthwave Mcaid - All Plans | $36 - $918 | 8% |
| Providers Care-All Plans | $54 - $1,376 | 12% |
| Blue Cross Blue Shield | $511 | 113% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Cheyenne County Hospital, the facility's cash median rate is $485.00, which is lower than the negotiated rates paid by most commercial payers. While the hospital's gross charge is $570.00, patients with high-deductible plans may find the cash price more affordable than their insurance allowed amounts, which range from $25 to $1,376 depending on the carrier. It is important to note that commercial payers like UnitedHealthcare and Aetna have negotiated rates significantly higher than the cash price, often due to administrative costs and contract structures that add 20% to 40% to the baseline. To maximize savings, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing costly insurance claims processing.
The facility's cash rate of $485.00 is also lower than the median negotiated rate of $502.00 and sits below the Medicare benchmark of $450.73 when adjusted for the 1.1x vs. Medicare factor, indicating that the commercial negotiated landscape varies widely. Since Cheyenne County Hospital is a Critical Access Hospital in Kansas, patients should be aware that balance billing is generally prohibited for emergency services under the No Surprises Act, though unexpected charges can still occur if ancillary services are out-of-network. If you receive a bill, always demand a full itemized statement rather than accepting a summary invoice, as over 80% of hospital bills