Blood transfusion
Facility: Smith County Memorial Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $713
- Cash Discount Price: $792
- vs. Medicare Baseline: 1.58x 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 | $420 - $841 | 93% |
| Blue Cross Blue Shield | $511 | 113% |
| Multiplan-All Plans | $540 - $757 | 120% |
| Wppa-All Plans | $564 - $791 | 125% |
| Midlands Choice-All Plans | $570 - $799 | 126% |
| Health Partners Of Ks Ppo-All Plans | $570 - $799 | 126% |
| UnitedHealthcare | $570 - $799 | 126% |
Consumer Guidance & Cost Commentary
For this blood transfusion service at Smith County Memorial Hospital in Smith Center, Kansas, the cash price is $792.00, which matches the facility's median negotiated rate of $713.00 and the cash median. This rate is significantly higher than the Medicare benchmark of $450.73, indicating a markup of 1.6 times the federal baseline. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find the cash price more affordable than their insurance negotiated rates, which range from $511 to $841 depending on the payer. It is important to note that commercial insurers often pay higher amounts than the cash price due to administrative costs and contract structures, so patients should verify their specific plan's allowed amount before scheduling to ensure they are not paying more than necessary.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services like laboratory tests are billed separately. To avoid these surprises, consumers should request a full itemized bill before paying, as summary invoices often hide unbundled codes or services not rendered. Additionally, since hospitals frequently offer prompt-pay discounts for upfront payment, patients should explicitly ask the billing department about self-pay or cash discount options prior to check-in. Given that over 80% of hospital bills contain errors, disputing any discrepancies in writing with the billing supervisor is the most effective way to reduce medical debt and ensure accurate reimbursement.