Blood transfusion
Facility: Meade District Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $677
- Cash Discount Price: $550
- vs. Medicare Baseline: 1.50x 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 | $677 | 150% |
Consumer Guidance & Cost Commentary
For this blood transfusion procedure at Meade District Hospital in Meade, Kansas, the cash price is $550.00, which matches the facility's median paid amount. While the hospital is in-network with Blue Cross Blue Shield, the negotiated rate for this service is $677.00, meaning the cash price is actually lower than what the insurance plan pays. This aligns with the principle that cash-pay options can be more cost-effective for patients with high-deductible plans, as the insurance negotiated rate often exceeds the cash price. Additionally, patients should inquire about prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid upfront, bypassing the administrative costs associated with insurance claims processing.
The facility's pricing is benchmarked against Medicare, which sets a rate of $450.73 for this code. The commercial cash rate of $550.00 represents a 1.5x markup compared to the Medicare amount, indicating the cost basis for this specific service. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still request an itemized bill to verify all charges. Since the facility is a government-owned Critical Access Hospital, patients are encouraged to confirm their specific self-pay or prompt-pay rates before scheduling to ensure they are not billed the full negotiated amount.