Blood transfusion
Facility: Stanton County Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $848
- Cash Discount Price: $893
- vs. Medicare Baseline: 1.88x 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 |
|---|---|---|
| Blue Cross Blue Shield | $490 - $848 | 109% |
| Healthy Blue Mcr Adv - All Other Plans | $875 | 194% |
| Healthy Blue Mcaid | $892 | 198% |
Consumer Guidance & Cost Commentary
For this blood transfusion service at Stanton County Hospital in Johnson, KS, the cash price of $893.00 is significantly higher than the state average for this procedure. While the facility's cash rate matches the cash median of $893.00, patients with high-deductible plans should consider that paying out-of-pocket might be more cost-effective than using insurance, as the negotiated rates for in-network payers like Blue Cross Blue Shield range from $490 to $848, yet the cash price remains the same as the gross charge. It is important to note that even though the facility is a Critical Access Hospital with government-local ownership, the lack of a specific self-pay or prompt-pay discount listed in this data means patients should directly contact the hospital to inquire about potential fee reductions for upfront payment, which can sometimes bypass standard insurance billing structures.
The billing process for this service involves a comparison against the Medicare benchmark of $450.73, which serves as the objective baseline for fair pricing. The commercial negotiated rate of $848.00 represents a markup over the Medicare amount, reflecting the administrative costs and contract dynamics typical of in-network agreements. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, meaning they should not immediately pay any unexpected balance bills without first disputing them with their insurer. Furthermore, if a summary bill is received, consumers should request a full itemized audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.