Blood transfusion
Facility: Graham County Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $454
- Cash Discount Price: $550
- vs. Medicare Baseline: 1.01x 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 |
|---|---|---|
| Medicare (plans) | $309 - $506 | 69% |
| UnitedHealthcare | $330 - $641 | 73% |
| Celtic Commercial-All Other Plans | $340 - $557 | 75% |
| Wppa (Providers Care)-All Plans | $391 - $641 | 87% |
| Medicaid / KanCare | $412 | 91% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Graham County Hospital in Hill City, KS, the facility's cash median price is $550.00, which matches the gross charge. This cash rate is notably higher than the state average for this service, as the median paid across all payers in Kansas is $413.00. While commercial insurers like UnitedHealthcare and Wppa (Providers Care) have negotiated rates ranging from $330 to $641, these amounts often exceed the cash price due to administrative overhead and contract dynamics. Patients with high-deductible plans may find it financially advantageous to pay the $550.00 cash rate directly, as this avoids the higher negotiated amounts that insurance carriers charge, provided the patient's deductible has not yet been met.
To secure the lowest possible cost, patients should proactively contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. It is also important to understand that while the No Surprises Act protects patients from balance billing for out-of-network emergency care at in-network facilities, unexpected ancillary services or non-emergency procedures may still trigger additional charges if not carefully reviewed. Before finalizing any payment, consumers should request a full itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included, ensuring they are not paying for unnecessary administrative fees or inflated list prices.