Blood transfusion
Facility: Stafford County Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $616
- Cash Discount Price: $633
- vs. Medicare Baseline: 1.37x 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 |
|---|---|---|
| Health Partners-All Plans | $81 - $808 | 18% |
| Va Ccn-All Plans | $85 - $850 | 19% |
| Humana | $85 - $850 | 19% |
| UnitedHealthcare | $85 - $850 | 19% |
| Medica Mcr- All Plans | $85 - $850 | 19% |
Consumer Guidance & Cost Commentary
For the Blood transfusion procedure (CPT 36430) at Stafford County Hospital in Stafford, KS, the cash median price is $633.00, which matches the facility's negotiated median paid rate of $616.00. This cash price is significantly lower than the commercial negotiated rates observed across five payers, with allowed amounts ranging from $81 to $850 depending on the specific insurance plan. For patients with high-deductible plans, paying the cash price of $633.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. Additionally, patients should verify if the facility offers self-pay or prompt-pay discounts, which can further reduce the final bill by bypassing administrative processing fees.
The facility's pricing is evaluated against the Medicare benchmark, where the Medicare amount for this service is $450.73. The cash price of $633.00 represents a 1.4x markup relative to the Medicare rate, which falls within the typical range of fair pricing (120% to 150% of Medicare) and is notably lower than the common commercial markup of 200% to 300%. While the data does not provide specific county or state average comparisons for this exact code, the facility's cash rate remains competitive when compared to the commercial negotiated ceilings. Patients are advised to request an itemized billing audit before payment to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.