Blood transfusion
Facility: Cloud County Health Center
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $440
- Cash Discount Price: $324
- vs. Medicare Baseline: 0.98x 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 |
|---|---|---|
| Mpi-All Plans | $57 - $1,060 | 13% |
| Pponext-All Plans | $199 - $1,060 | 44% |
| Aetna | $417 - $1,038 | 93% |
| Health Partners - All Plans | $440 - $1,060 | 98% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Cloud County Health Center in Concordia, KS, the facility's cash median rate of $324.00 is lower than the state average for this service. While the facility's negotiated rates with major payers like Aetna and Health Partners range from $417 to $440, these amounts are still below the maximum allowed amounts seen across some payer plans, such as Mpi-All Plans which allows up to $1,060. It is important to note that while cash payments may appear cheaper, patients with high-deductible plans should verify if their insurance negotiated rate exceeds the cash price, as paying out-of-pocket might result in higher out-of-pocket costs if the deductible has not been met. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final bill by bypassing administrative claim processing costs.
The facility's billing practices align with federal protections under the No Surprises Act, which bans balance billing for emergency and non-emergency services from out-of-network providers at in-network facilities, ensuring patients are not billed for the difference between the chargemaster and the insurance allowed amount. However, consumers should remain vigilant regarding itemized billing audits, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If a patient receives a summary bill, they should demand a full, line-by-line CPT-coded statement before agreeing to any payment plan or signing consent waivers that might waive their rights to dispute out-of-network ancillary services. By comparing the facility's