Blood transfusion
Facility: Greeley County Health Services
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $234
- Cash Discount Price: $791
- vs. Medicare Baseline: 0.52x 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 |
|---|---|---|
| Medicaid / KanCare | $234 | 52% |
| Aetna | $234 | 52% |
| Blue Cross Blue Shield | $669 | 148% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Greeley County Health Services, the cash median price is $791.00, which is significantly lower than the facility's negotiated rates with major payers like Blue Cross Blue Shield ($669) and Medicaid/KanCare ($234). While the facility's negotiated rate of $234.00 is notably lower than the gross charge of $1,130.00, it is important to note that commercial negotiated rates often include administrative overhead and contract ceilings that can exceed the actual cost of care. In this specific case, the cash price of $791.00 is higher than the negotiated rate of $234.00, suggesting that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price might result in a higher total cost than the insurance allowed amount, depending on the specific plan structure. However, patients should always verify their deductible status before assuming insurance will cover the full negotiated rate, as many plans require the patient to pay the full negotiated amount until the deductible is met.
To ensure you are getting the best possible price, we recommend requesting a "prompt-pay" discount from the hospital before scheduling your visit, as facilities often offer reductions of 20% to 50% for upfront payments that bypass costly insurance billing cycles. Additionally, since this facility is a Critical Access Hospital in Tribune, KS, with a government-local ownership structure, you may find that self-pay or cash-pay options provide more predictable pricing compared to variable insurance negotiations. Always ask for an itemized bill to review the specific CPT codes and