Blood transfusion
Facility: Great Plains Of Sabetha
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $694
- Cash Discount Price: $728
- vs. Medicare Baseline: 1.54x 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 |
|---|---|---|
| Celtic Mcr Adv | $221 - $533 | 49% |
| Aetna | $223 - $1,035 | 49% |
| Celtic Comm Exchange-All Other Plans | $276 - $666 | 61% |
| Great West Healthcare-All Plans | $361 - $871 | 80% |
| UnitedHealthcare | $395 - $1,025 | 88% |
| Century/Wppa/Providers-All Plans | $404 - $974 | 90% |
| Multiplan-Phcs-All Plans | $404 - $974 | 90% |
| Humana | $404 - $974 | 90% |
| Cigna | $404 - $974 | 90% |
| Federated Mutual Ins-All Plans | $408 - $984 | 91% |
| Blue Cross Blue Shield | $425 - $1,025 | 94% |
| Medicaid / KanCare | $425 - $1,025 | 94% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Great Plains Of Sabetha in Sabetha, Kansas, the cash price is $728.00, which matches the facility's cash median. This rate is significantly higher than the state average, as indicated by a Medicare benchmarking ratio of 1.5, meaning the facility's pricing is 50% above the federal baseline. While commercial insurance plans like Aetna and UnitedHealthcare negotiate rates ranging from $223 to $1,025, these negotiated amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the insurance negotiated rates can be substantially higher than the out-of-pocket cash cost.
To minimize unexpected costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling services, as these upfront payment incentives can reduce the final bill. It is also critical to request an itemized billing audit if you receive a summary bill, as over 80% of hospital invoices contain errors such as unbundled codes or charges for services not rendered. Under the No Surprises Act, patients are protected from balance billing for emergency care and non-emergency services at in-network facilities, so any surprise charges should be disputed immediately with the insurer rather than paid out of pocket. Always verify your specific plan's deductible status and allowed amounts before proceeding, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket expenses than paying cash.