Blood transfusion
Facility: Greenwood County Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $498
- Cash Discount Price: $654
- vs. Medicare Baseline: 1.10x 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 |
|---|---|---|
| Triwest - All Plans | $161 - $292 | 36% |
| Tricare | $189 - $343 | 42% |
| UnitedHealthcare | $189 - $686 | 42% |
| Choicecare Mcr Adv - All Plans | $189 - $343 | 42% |
| Integrated Health Plan - All Plans | $338 - $613 | 75% |
| First Health Ccn Network | $382 - $694 | 85% |
| First Health - All Other Plans | $382 - $694 | 85% |
| Beech Street - All Plans | $382 - $694 | 85% |
| Preferred Hs (Coventry) - All Plans | $405 - $735 | 90% |
| Principal Health Care Inc - All Plans | $428 - $776 | 95% |
| Amerigroup Mcaid-All Plans | $450 - $817 | 100% |
| Medicaid / KanCare | $450 - $817 | 100% |
| Blue Cross Blue Shield | $485 - $511 | 108% |
| Providrs Care/Wppa - All Plans | $675 - $1,226 | 150% |
Consumer Guidance & Cost Commentary
For the CPT code 36430, representing a blood transfusion at Greenwood County Hospital in Eureka, Kansas, the facility's cash median price is $654.00, which is notably higher than the state average of $383.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare's highest negotiated rate reaches $686, surpassing the cash price, whereas Blue Cross Blue Shield's negotiated range ($485–$511) remains below the cash median. This dynamic suggests that for patients with high-deductible plans, paying the cash price directly might result in lower out-of-pocket costs compared to using insurance, provided the patient's deductible has been met.
To secure the most favorable rate, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce bills by 20% to 50% by bypassing insurance claims processing costs. It is also important to distinguish between the facility's gross charge of $817.00 and the actual amounts paid; the Medicare benchmark for this service is $450.73, serving as a reliable baseline to evaluate if commercial rates are appropriately marked up. If you receive a bill, always demand a full itemized statement to verify that no services were rendered or that codes were unbundled, as over 80% of hospital bills contain errors that can be corrected through a formal written audit.