Blood transfusion
Facility: Minneola District Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $695
- Cash Discount Price: $574
- vs. Medicare Baseline: 1.54x 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 |
|---|---|---|
| Humana | $293 - $1,055 | 65% |
| UnitedHealthcare | $293 - $1,575 | 65% |
| Va Community Care Program-All Plans | $293 - $1,055 | 65% |
| Providrs Care Network-All Plans | $372 - $1,339 | 83% |
| Corporate Plan Management-All Plans | $372 - $1,339 | 83% |
| Preferred Health Care (Coventry)-All Other Plans | $394 - $1,418 | 87% |
| Triwest-All Plans | $394 - $1,418 | 87% |
| Phc (Coventry) Leased Network | $416 - $1,496 | 92% |
| Health Partners Of Kansas-All Plans | $416 - $1,496 | 92% |
| Aetna | $416 - $1,575 | 92% |
| Medicaid / KanCare | $438 - $1,575 | 97% |
| Blue Cross Blue Shield | $516 | 114% |
Consumer Guidance & Cost Commentary
For the blood transfusion service (CPT 36430) at Minneola District Hospital, the cash price of $574.00 is lower than the facility's negotiated rates, which range from $660.00 to $695.00 depending on the insurance plan. This facility is a Critical Access Hospital in Kansas, and while specific county or state average data was not provided in the report, the cash price represents a significant discount compared to the commercial rates charged to insured patients. Because commercial insurance contracts often include administrative overhead and negotiated markups, paying cash upfront can result in immediate savings for patients who have not yet met their deductible or are using high-deductible plans.
To maximize these savings, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling their visit, as billing systems may automatically submit claims to insurance carriers if a card is on file, thereby voiding any cash agreement. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, this protection does not apply to self-pay discounts; therefore, signing a waiver to bypass insurance submission is necessary to secure the lower cash rate. Given that the Medicare benchmark for this service is $450.73, the cash price of $574.00 remains within a reasonable range relative to the federal cost baseline, though patients should always verify their specific plan's allowed amount to ensure they are not being overcharged.