Blood transfusion
Facility: St Luke Hospital & Living Center
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $218
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.48x 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 | $195 - $260 | 43% |
| Humana | $195 - $260 | 43% |
| Bluestem Pace | $195 - $260 | 43% |
| Kansas Department Of Health And Environment | $195 - $260 | 43% |
| UnitedHealthcare | $195 - $260 | 43% |
| Va Ccn | $195 - $260 | 43% |
| Ambetter / Centene | $197 - $263 | 44% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rates range from $195 to $263 across seven major payers, with a median negotiated amount of $218.00. This facility, a Critical Access Hospital owned by a Government Hospital District, charges a gross amount of $426.00, which is significantly higher than the Medicare benchmark of $450.73. While the data does not provide a specific cash or median paid figure, patients should note that cash-pay options can sometimes be more cost-effective than insurance negotiated rates, particularly for those with high-deductible plans where the insurer's allowed amount might exceed the cash price. It is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% if settled upfront.
When reviewing your bill, be aware that commercial insurance rates often include administrative overhead and do not reflect the true cost of care, which is better represented by the Medicare benchmark. Although this specific report does not list state or county average comparisons, it is important to understand that Medicare rates serve as a scientifically validated baseline for evaluating hospital pricing markups. If you receive a bill, ensure you have an itemized statement that lists specific CPT codes to identify any errors, unbundled charges, or services not rendered, as over 80% of hospital bills contain inaccuracies. If you are concerned about unexpected charges, you may have protections under the No Surprises Act if you received care from an out-of-network provider at an in-network facility, allowing