Blood transfusion
Facility: Sheridan County Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $710
- Cash Discount Price: $812
- vs. Medicare Baseline: 1.58x 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 Insurance | $491 | 109% |
| Blue Cross Blue Shield | $710 | 158% |
| UnitedHealthcare | $771 | 171% |
Consumer Guidance & Cost Commentary
For this blood transfusion procedure at Sheridan County Hospital in Hoxie, Kansas, the cash price is $812.00, which matches the facility's median paid amount. While the hospital's negotiated rate with Blue Cross Blue Shield is $710.00, this is lower than the cash price, meaning patients with high-deductible plans or those without insurance might save money by paying cash directly. It is important to note that the facility is a Critical Access Hospital with government-local ownership, and while the negotiated rate is lower than the cash price, patients should still verify their specific plan details before scheduling.
The Medicare benchmark for this service is $450.73, which serves as a baseline for evaluating the facility's pricing. The cash price of $812.00 is 1.6 times the Medicare rate, reflecting the standard markup for commercial services. Since the negotiated rate of $710.00 is also higher than the Medicare amount, patients should be aware that commercial rates often exceed the federal baseline due to administrative costs and contract structures. To ensure you are receiving the best possible rate, we recommend requesting an itemized bill to review all CPT codes and checking for any available self-pay or prompt-pay discounts before finalizing payment.