Blood transfusion
Facility: Neosho Memorial Regional Medical Center
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $1,127
- Cash Discount Price: $1,976
- vs. Medicare Baseline: 2.50x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 250% of the Medicare baseline (a markup of 150%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $257 | 57% |
| Blue Cross Blue Shield | $570 - $1,127 | 126% |
| Tricare | $587 - $1,086 | 130% |
| Medicare (plans) | $610 - $1,127 | 135% |
| Medadv_Allwell | $610 - $1,127 | 135% |
| Aetna | $610 - $1,127 | 135% |
| Humana | $610 - $1,127 | 135% |
| Medadv_Uhc | $610 - $1,127 | 135% |
| Va_Ccn | $610 - $1,127 | 135% |
| Ambetter / Centene | $960 - $1,775 | 213% |
| Wppa_Providrscare | $1,581 - $2,924 | 351% |
| United | $1,585 - $2,931 | 352% |
| Coventry | $1,810 - $3,347 | 402% |
| Hpk | $1,810 - $3,347 | 402% |
| Cigna | $1,810 - $3,347 | 402% |
Consumer Guidance & Cost Commentary
For the procedure code 36430 (Blood transfusion) at Neosho Memorial Regional Medical Center in Chanute, KS, the facility's cash median rate of $1,976.00 is significantly higher than the Medicare benchmark of $450.73, reflecting a markup common in commercial pricing. While the facility's negotiated rate of $1,127.00 is lower than its cash price, it remains above the Medicare benchmark, illustrating that commercial contracts often exceed the federal cost baseline. Patients should note that cash payments can sometimes be more cost-effective than using insurance if the patient's deductible has not been met, as the negotiated rate may exceed the cash price for those with high-deductible plans. Additionally, this facility is a Critical Access Hospital with government-local ownership, which may influence its pricing structure compared to larger urban centers.
When evaluating costs, it is important to compare these rates against state and county averages to understand relative pricing, though specific county or state average figures were not provided in the available data for this code. The facility offers a range of negotiated rates across 15 different payers, with the lowest allowed amount being $257 from Medicaid/KanCare and the highest reaching $3,347 from providers like Coventry and Cigna. To minimize out-of-pocket expenses, patients should verify their specific plan's allowed amount before scheduling and inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront. Finally, if a balance bill arises from an out-of-network service, patients should request an itemized billing audit to identify errors or unb