Blood transfusion
Facility: Hodgeman County Health Center
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $545
- Cash Discount Price: $619
- vs. Medicare Baseline: 1.21x 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 | $490 - $516 | 109% |
| UnitedHealthcare | $495 - $735 | 110% |
| Triwest - All Plans | $495 | 110% |
| Humana | $495 | 110% |
| Medicaid / KanCare | $495 - $774 | 110% |
| Aetna | $619 | 137% |
| First Health - All Plans | $697 | 155% |
| Health Partners - All Plans | $735 | 163% |
| Wppa (Provdrscare) - All Plans | $735 | 163% |
Consumer Guidance & Cost Commentary
For the CPT code 36430, representing a blood transfusion, Hodgeman County Health Center in Jetmore, Kansas, lists a gross charge of $774.00. While the facility's cash median rate is $619.00, commercial insurance payers negotiate rates that generally range between $490 and $774, with UnitedHealthcare and Medicaid/KanCare showing the widest spread. It is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures; for patients with high-deductible plans, paying the cash median of $619.00 upfront may result in lower out-of-pocket costs compared to the negotiated rates their insurance would allow. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed before insurance claims are processed.
When evaluating the cost of this service, it is more accurate to compare rates against the Medicare benchmark rather than the hospital's full chargemaster. The Medicare amount for this procedure is $450.73, and the facility's cash rate of $619.00 represents a markup of 1.2 times the Medicare amount. This benchmarking approach reveals the true cost baseline, as commercial rates are frequently inflated relative to this federal standard. To ensure you are not overpaying, request a detailed, itemized bill to identify any errors or unbundled charges, as over 80% of hospital bills contain discrepancies. Finally, if you are using insurance, check your deductible status beforehand, as paying the negotiated rate before meeting your deductible can significantly increase your financial burden.