Blood transfusion
Facility: Amberwell Atchison Association
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $587
- Cash Discount Price: $1,446
- vs. Medicare Baseline: 1.30x 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 |
|---|---|---|
| Va Ccn - All Plans | $298 - $477 | 66% |
| Humana | $298 - $1,551 | 66% |
| Superior Select Mcr Adv - All Plans | $298 - $477 | 66% |
| UnitedHealthcare | $298 - $2,594 | 66% |
| Triwest - All Plans | $298 - $477 | 66% |
| Ambetter / Centene | $462 - $740 | 103% |
| Blue Cross Blue Shield | $490 - $516 | 109% |
| Aetna | $497 - $795 | 110% |
| Cigna | $497 - $795 | 110% |
| Oscar - All Plans | $678 - $1,084 | 150% |
| Centrus Health Direct - All Plans | $678 - $1,084 | 150% |
| Multiplan - All Plans | $705 - $1,128 | 156% |
| Wppa Providrs Care - All Plans | $814 - $1,301 | 181% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Amberwell Atchison Association, the cash median price is $1,446.00, which is notably higher than the state of Kansas average. While commercial insurance plans like Humana and UnitedHealthcare negotiate rates ranging from $298 to over $1,500 depending on the specific plan, patients with high-deductible plans might find the cash price more affordable if their insurance negotiated rate exceeds this amount. It is important to note that the facility's cash rate is significantly higher than the Medicare benchmark of $450.73, indicating a markup typical of commercial billing structures where administrative costs and profit margins are factored in.
Patients should be aware that while the facility offers a median negotiated rate of $587.00 for in-network members, this does not guarantee the lowest possible price for every individual plan, as rates vary widely across the 13 payers listed. To potentially reduce costs, individuals should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling care, as paying in full upfront can often bypass the administrative overhead associated with insurance claims. Additionally, if a balance bill arises from an out-of-network service, patients should verify its legality under the No Surprises Act and request a formal itemized audit to identify any unbundled codes or services not rendered, ensuring they are not paying for unnecessary charges.