Blood transfusion
Facility: F W Huston Medical Center
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $655
- Cash Discount Price: $680
- vs. Medicare Baseline: 1.45x 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% |
| Aetna | $638 | 142% |
| Humana | $672 | 149% |
| Cigna | $722 | 160% |
Consumer Guidance & Cost Commentary
For the CPT code 36430, representing a blood transfusion at F W Huston Medical Center in Winchester, KS, the facility's cash median rate is $680.00, which is lower than the negotiated rates charged to in-network insurers like Blue Cross Blue Shield ($516), Aetna ($638), and Humana ($672). While the facility's cash price is competitive, it is important to note that commercial insurance contracts often include administrative overheads that can inflate the final allowed amount compared to direct cash payment. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $680.00 rate avoids the multi-layered billing structures inherent in insurance claims processing.
To ensure you receive the most accurate pricing, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final cost. Additionally, if you are using insurance, be aware that the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities, meaning you should not be billed for the difference between the provider's full chargemaster rate and your insurance allowed amount. If you receive a bill that seems inconsistent with the data above, request a formal itemized audit to review every line item for errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain discrepancies that can be corrected through written dispute.