Blood transfusion
Facility: Children'S Mercy South
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $590
- Cash Discount Price: $521
- vs. Medicare Baseline: 1.31x 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 |
|---|---|---|
| Blue Cross Blue Shield | $269 - $1,122 | 60% |
| UnitedHealthcare | $270 - $1,019 | 60% |
| Healthy Blue | $288 - $1,078 | 64% |
| Medicaid / KanCare | $301 | 67% |
| Cigna | $314 - $1,054 | 70% |
| Medica | $382 - $884 | 85% |
| Aetna | $393 - $1,031 | 87% |
| Wppa Providrs Care | $426 - $985 | 95% |
| Centivo | $426 - $985 | 95% |
| Quiktrip | $426 - $987 | 95% |
| Wellfit/Centrus | $426 - $985 | 95% |
| Orscheln | $426 - $985 | 95% |
| Health Midwest Comprehensive Care | $426 - $987 | 95% |
| Nebraska Furniture Mart | $426 - $985 | 95% |
| Humana | $436 - $1,008 | 97% |
| Coxhealth Network | $485 - $1,122 | 108% |
| Coventry Health Care Of Kansas | $485 - $1,122 | 108% |
| Mercy Health | $491 - $1,137 | 109% |
| Multiplan | $498 - $1,152 | 110% |
| American Healthcare Alliance | $557 - $1,289 | 124% |
| Healthlink | $576 - $1,334 | 128% |
| National Preferred Provider Network | $590 - $1,364 | 131% |
| Home State Health | $947 | 210% |
Consumer Guidance & Cost Commentary
For CPT code 36430 (Blood transfusion) at Children's Mercy South in Overland Park, KS, the facility's gross charge is $1,086.00. While the facility offers a cash median price of $521.00, which is significantly lower than the negotiated rates paid by most insurance plans, patients should be aware that commercial payers often negotiate rates well above the cash price. For instance, Blue Cross Blue Shield's range spans from $269 to $1,122, and UnitedHealthcare's range is $270 to $1,019, meaning many insured patients could pay substantially more than the cash rate. The facility's cash price is also notably lower than the state average for this procedure, which is $590.00, and the Medicare benchmark of $450.73.
Patients with high-deductible plans may find the cash option most beneficial, as paying upfront can bypass the administrative overhead and potential balance billing associated with insurance claims. To secure the lowest possible rate, it is essential to request a "self-pay" or "prompt-pay" discount before scheduling, as billing systems often default to insurance processing once a card is on file. If you are using insurance, you should verify your specific plan's negotiated rate, as some in-network carriers may pay amounts exceeding the cash price. Additionally, if you receive a bill that includes charges for services not rendered or unbundled components, you should request a formal itemized audit to ensure accuracy before making any payments.