Blood transfusion
Facility: Medicine Lodge Memorial Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $616
- Cash Discount Price: $649
- 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 |
|---|---|---|
| Tricare | $74 - $721 | 16% |
| Humana | $84 - $819 | 19% |
| Aetna | $85 - $900 | 19% |
| Hpk-All Plans | $87 - $855 | 19% |
| UnitedHealthcare | $87 - $855 | 19% |
| Medicaid / KanCare | $92 - $900 | 20% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the cash price is $649.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average for Kansas, where the typical cash price for this service is $450.73. While commercial insurance plans like Tricare, Humana, and Aetna negotiate rates ranging from $74 to $900 depending on the specific plan, these negotiated amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the insurance negotiated rates can be substantially higher than the out-of-pocket cost. It is important to verify your specific plan's allowed amount before scheduling, as some in-network contracts may result in higher out-of-pocket costs than paying cash outright.
To ensure you are not overcharged, you should request a full itemized bill that lists every specific CPT code and unit cost, rather than accepting a summary invoice that obscures individual charges. Over 80% of hospital bills contain errors such as double-billing or unbundled services, so a line-by-line review is essential before making any payment. Additionally, if you are billed for services from out-of-network providers at this in-network facility, the No Surprises Act protects you from balance billing for emergency and non-emergency care; if you receive such a bill, you should dispute it with your insurer rather than paying immediately. Finally, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if you pay in full upfront