Blood transfusion
Facility: Logan County Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $950
- Cash Discount Price: $200
- vs. Medicare Baseline: 2.11x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 211% of the Medicare baseline (a markup of 111%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Humana | $424 - $467 | 94% |
| Blue Cross Blue Shield | $516 | 114% |
| Health Partners - All Plans | $950 - $1,045 | 211% |
| Medicaid / KanCare | $1,000 - $1,100 | 222% |
Consumer Guidance & Cost Commentary
For this blood transfusion service at Logan County Hospital in Oakley, Kansas, the negotiated rates paid by insurance carriers range from $424 to $1,100, with a median negotiated amount of $950. This figure is notably higher than the facility's cash price of $200 and exceeds the Medicare benchmark of $450.73 by a factor of 2.1. While commercial insurance contracts often protect members with a ceiling rate, these negotiated amounts frequently include administrative overhead and do not reflect the lowest possible cost for the patient. In cases where a patient has a high deductible or limited insurance coverage, paying the cash price of $200 could result in significant savings compared to the insurance negotiated rate, provided the patient understands their out-of-pocket responsibilities.
Patients should proactively contact the hospital to confirm if "self-pay" or "prompt-pay" discounts are available, as these programs can reduce bills by 20% to 50% for upfront payments. It is important to request a full itemized bill before scheduling any procedures to ensure no errors or unbundled charges are included, as over 80% of hospital bills contain discrepancies. Additionally, while the No Surprises Act protects against balance billing for emergency care at in-network facilities, patients should verify that all ancillary services, such as laboratory tests, are covered under the same network agreement to avoid unexpected additional charges.