Blood transfusion
Facility: Republic County Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $748
- Cash Discount Price: $626
- vs. Medicare Baseline: 1.66x 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 |
|---|---|---|
| Rural Carriers-All Plans | $103 - $1,165 | 23% |
| Aetna | $109 - $1,234 | 24% |
| Meritain-All Plans | $109 - $1,234 | 24% |
| UnitedHealthcare | $111 - $1,261 | 25% |
| Cigna | $115 - $1,302 | 26% |
| Midlands Choice-All Plans | $115 - $1,302 | 26% |
| First Health-All Plans | $115 - $1,302 | 26% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Republic County Hospital in Belleville, KS, the facility's cash median rate is $626.00, which is lower than the state average of $742.00 and the median negotiated rate of $748.00. While commercial payers like Aetna, UnitedHealthcare, and Cigna negotiate rates ranging from $109 to $1,302, patients with high-deductible plans may find paying the cash price of $626.00 more cost-effective if their insurance allowed amount exceeds this figure. It is important to note that the facility's cash rate is also significantly lower than the Medicare benchmark of $450.73 when adjusted for the 1.7x multiplier, highlighting that commercial negotiated rates often exceed the true cost baseline established by federal reimbursement standards.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, unexpected ancillary services or out-of-network providers could still result in additional charges. To minimize costs, consumers are encouraged to request a full itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, since the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should explicitly ask about self-pay or prompt-pay discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the administrative overhead and collection fees associated with insurance claims.