Blood transfusion
Facility: Hospital District #6 Patterson Health Center
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $603
- Cash Discount Price: $536
- vs. Medicare Baseline: 1.34x 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 | $485 - $511 | 108% |
| UnitedHealthcare | $603 - $670 | 134% |
| Providers Care (Wppa)-All Plans | $1,173 | 260% |
Consumer Guidance & Cost Commentary
For this blood transfusion service at Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash median rate of $536.00 is notably lower than the state average for this procedure. While the facility's negotiated rate with UnitedHealthcare is $603.00, patients with high-deductible plans or those without insurance may find the cash price more advantageous, as it avoids the administrative markup often found in commercial contracts. It is important to note that the facility's gross charge of $670.00 represents the maximum list price before any discounts; however, the cash rate of $536.00 already reflects a significant reduction from this baseline.
Patients should be aware that commercial insurance rates can sometimes exceed cash prices due to the costs of claims processing and contract management. For instance, the negotiated rate with Providers Care (Wppa)-All Plans is $1,173.00, which is substantially higher than both the cash and UnitedHealthcare rates. To minimize costs, consumers should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the insurance billing cycle. Additionally, if a balance bill arises from an out-of-network ancillary service, patients should verify the legality of the charge under the No Surprises Act and request a formal itemized audit to identify any unbundled codes or services not rendered.