Blood transfusion
Facility: Lincoln County Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $516
- Cash Discount Price: $586
- vs. Medicare Baseline: 1.14x 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 | $516 - $1,800 | 114% |
Consumer Guidance & Cost Commentary
For this blood transfusion service at Lincoln County Hospital in Lincoln, KS, the cash median price is $586.00, which is lower than the facility's negotiated rate of $516.00 and significantly below the gross charge of $651.00. While Blue Cross Blue Shield plans in this area have negotiated rates ranging from $516 to $1,800, patients with high-deductible plans may find paying the cash price upfront more cost-effective than relying on insurance, as the cash rate avoids the administrative overhead and potential higher negotiated caps. It is important to note that this facility is a Critical Access Hospital owned by the local government, and while the cash price is favorable, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling to ensure the lowest possible rate is applied, as billing systems often default to insurance processing once a card is on file.
The facility's pricing is benchmarked against federal standards, with the Medicare amount for this procedure set at $450.73. The cash price of $586.00 represents a markup of approximately 1.1 times the Medicare rate, which falls within the range of fair pricing typically defined as 120% to 150% of Medicare, avoiding the excessive markups sometimes seen in commercial billing. Since the data indicates no specific county or state average was provided for this specific code, the comparison is limited to the facility's internal negotiated versus cash rates and the federal Medicare baseline. To ensure accuracy, patients should request a full itemized billing audit before paying, as over 80% of hospital bills contain errors such as double-billing or unb