Blood transfusion
Facility: Memorial Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $564
- Cash Discount Price: $663
- vs. Medicare Baseline: 1.25x 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 |
|---|---|---|
| Tricare | $42 - $558 | 9% |
| Ambetter / Centene | $47 - $614 | 10% |
| Blue Cross Blue Shield | $545 | 121% |
| Humana | $558 | 124% |
| Medicare (plans) | $564 | 125% |
| Coventry - All Other Plans | $1,004 | 223% |
| Health Partners Of Kansas - All Plans | $1,060 | 235% |
| Preferred Healthcare-All Plans | $1,060 | 235% |
| Wppa/Providers Care-All Plans | $1,562 | 347% |
Consumer Guidance & Cost Commentary
For this blood transfusion service at Memorial Hospital in Abilene, KS, the cash price of $663.00 is significantly lower than the negotiated rates charged by most major insurance payers, which range from $42 to $1,562. While the facility's cash rate aligns with the state average for this procedure, commercial insurance contracts often result in higher out-of-pocket costs for patients who have not yet met their deductibles. For instance, the median negotiated rate across payers is $564.00, yet many plans still face bills exceeding $1,000 due to specific plan structures or out-of-network ancillary services. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $663.00 rate avoids the administrative markups and potential balance billing that can occur when insurance claims are processed.
To ensure you receive the most accurate pricing, it is essential to request a prompt-pay discount before scheduling your visit, as hospitals often offer immediate fee reductions for upfront payments that bypass standard insurance billing cycles. If you are billed by an out-of-network provider, remember that the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities, so do not sign away your rights to dispute unexpected charges. Furthermore, always demand a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. By comparing your specific plan's allowed amount against the facility's cash rate and seeking a formal audit if discrepancies arise, you can avoid unnecessary debt and ensure you are paying a fair