Blood transfusion
Facility: Morris County Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $450
- Cash Discount Price: $444
- vs. Medicare Baseline: 1.00x 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $43 | 10% |
| Choice Care Mcr Adv-All Plans | $176 - $450 | 39% |
| UnitedHealthcare | $176 - $1,155 | 39% |
| Blue Cross Blue Shield | $176 - $516 | 39% |
| Va Ccn-All Plans | $176 - $450 | 39% |
| Coventry Mcr | $176 - $450 | 39% |
| Cigna | $326 - $836 | 72% |
| Aetna | $403 - $1,035 | 89% |
| Multiplan-All Plans | $405 - $1,040 | 90% |
| Coventry Comm-All Other Plans | $405 - $1,040 | 90% |
Consumer Guidance & Cost Commentary
For the Blood transfusion procedure (CPT 36430) at Morris County Hospital in Council Grove, KS, the cash price is $444.00, which is lower than the facility's gross charge of $740.00. While the hospital is a Critical Access Hospital owned by the local government, patients should note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare's negotiated range spans from $176 to $1,155, and Aetna's range is $403 to $1,035. If you have a high-deductible plan or have not yet met your deductible, paying the cash price of $444.00 upfront could result in significant savings compared to the potential out-of-pocket costs associated with insurance claims, provided you verify your specific plan's allowed amount.
To ensure you are not overcharged, it is crucial to request an 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 No Surprises Act prohibits balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, you should dispute any unexpected bills immediately rather than paying them out of fear of credit damage. Finally, do not assume that being in-network guarantees the lowest price; always ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within a short window, effectively bypassing costly insurance billing cycles.