CMS Price Transparency Data

Blood transfusion

Facility: Lee's Summit Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,172
Cash Discount Price: $3,440
vs. Medicare Baseline: 2.60x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Lee's Summit Medical Center is $1,172. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,440. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.60x the Medicare baseline. Located in 2100 Se Blue Parkway, Lees Summit, MO.

Cash / Self-Pay

$3,440

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,172

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$450.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $450.73 (100%)

Cash / Self-Pay: $3,440 (763%)

Insurance Median: $1,172 (260%)

Cash: $3,440 (763% of Medicare)

Ins. Median: $1,172 (260% of 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 260% of the Medicare baseline (a markup of 160%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
United	$257 - $2,072	57%
Healthyblue	$263	58%
Medicaid / KanCare	$265	59%
Aetna	$268 - $4,111	59%
Amerigroup	$268	59%
Unicare	$268	59%
Home State Health Plan	$270	60%
Blue Cross Blue Shield	$297 - $1,980	66%
Ambetter / Centene	$425 - $857	94%
Oscar	$434 - $875	96%
Wppa Providrs Care Network	$457 - $921	101%
Humana	$482 - $1,941	107%
Cigna	$566 - $3,684	126%
Multiplan	$600 - $3,408	133%
Corvel Corporation	$713 - $2,993	158%
Oha Network	$743 - $2,303	165%
Universal Healthcare	$799 - $1,995	177%
Coventry	$918 - $1,851	204%
Coventry Kc Mo	$936 - $1,888	208%
College Park Family Care Center	$982 - $1,980	218%
Focus Healthcare Mgmt, Inc	$1,712 - $3,454	380%
Cco, Inc.	$1,941 - $3,914	431%
Nhc Advantage	$2,550	566%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $3,440.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 36430.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lee's Summit Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 36430.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.