Blood transfusion
Facility: Clara Barton Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $511
- Cash Discount Price: $524
- vs. Medicare Baseline: 1.13x 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 |
|---|---|---|
| 6 Degrees Health - All Plans | $382 - $666 | 85% |
| Wppa-All Plans | $436 - $762 | 97% |
| Aetna | $490 - $857 | 109% |
| UnitedHealthcare | $490 - $857 | 109% |
| Phcs - All Plans | $490 - $857 | 109% |
| Hlth Partners Of Ks-All Plans | $501 - $876 | 111% |
| Blue Cross Blue Shield | $511 | 113% |
Consumer Guidance & Cost Commentary
For the CPT code 36430, representing a blood transfusion, Clara Barton Hospital in Hoisington, KS, lists a gross charge of $749.00. While the facility's cash median rate is $524.00 and the median negotiated rate for in-network payers is $511.00, commercial insurance contracts often result in higher out-of-pocket costs for patients who have not yet met their deductibles. The data indicates that commercial negotiated rates can sometimes exceed the cash price, making self-pay or prompt-pay options potentially more affordable for those with high-deductible plans. Patients are encouraged to verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can bypass the administrative overhead and multi-layered billing structures that inflate commercial rates.
When evaluating the value of this service, it is important to compare facility rates against the federal Medicare benchmark rather than the hospital's inflated chargemaster. The Medicare amount for this procedure is $450.73, and the facility's cash rate of $524.00 represents a markup of 115% relative to this baseline, which aligns with the range of fair pricing typically defined between 120% and 150% of Medicare. Since over 80% of hospital bills contain errors, consumers should request a full itemized CPT-coded bill to identify any unbundled charges or services not rendered before finalizing payment. By understanding that commercial rates often average 200% to 300% of Medicare while fair pricing sits closer to 120