Blood transfusion
Facility: Wilson Medical Center
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $541
- Cash Discount Price: $754
- vs. Medicare Baseline: 1.20x 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 |
|---|---|---|
| Ambetter / Centene | $225 - $1,020 | 50% |
| Aetna | $225 - $1,020 | 50% |
| Tricare | $225 - $541 | 50% |
| UnitedHealthcare | $225 - $949 | 50% |
| Humana | $225 - $541 | 50% |
| Cigna | $340 - $816 | 75% |
| Mulitplan-All Plans | $391 - $938 | 87% |
| Health Partners-All Plans | $391 - $938 | 87% |
| Blue Cross Blue Shield | $425 - $1,020 | 94% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Wilson Medical Center in Neodesha, KS, the facility's cash median rate is $754.00, which is notably higher than the state average of $533.00. While commercial insurance plans like Ambetter, Aetna, and UnitedHealthcare negotiate rates ranging from $225 to $1,020, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that commercial negotiated rates frequently include administrative overhead and do not reflect the true cost of care; comparing these rates to the Medicare benchmark of $450.73 reveals that the facility's cash price is approximately 167% of the Medicare rate, which aligns with fair pricing standards rather than inflated chargemaster lists.
Patients should be aware that balance billing is generally prohibited for emergency services and non-emergency care at in-network facilities under the No Surprises Act, though unexpected ancillary services from out-of-network providers could still trigger additional charges. To ensure you receive the best possible price, always request a self-pay or prompt-pay discount before scheduling your visit, as paying in full upfront can often reduce the bill by 20% to 50% by bypassing costly insurance claims processing. If you receive a summary bill, do not accept it as final; instead, demand 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.