CMS Price Transparency Data

Blood transfusion

Facility: The Children's Mercy Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $606
Cash Discount Price: $521
vs. Medicare Baseline: 1.34x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at The Children's Mercy Hospital is $606. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $521. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.34x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$521

Average discount available for prompt cash payment at this facility.

Insurance Median

$606

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: $521 (116%)

Insurance Median: $606 (134%)

Cash: $521 (116% of Medicare)

Ins. Median: $606 (134% 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.

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
Blue Cross Blue Shield	$269 - $1,122	60%
UnitedHealthcare	$270 - $1,078	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%
Centivo	$426 - $985	95%
Health Midwest Comprehensive Care	$426 - $987	95%
Nebraska Furniture Mart	$426 - $985	95%
Orscheln	$426 - $985	95%
Quiktrip	$426 - $987	95%
Wellfit/Centrus	$426 - $985	95%
Wppa Providrs Care	$426 - $985	95%
Humana	$436 - $1,008	97%
Coventry Health Care Of Kansas	$485 - $1,122	108%
Coxhealth Network	$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%

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 $521.
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 The Children's Mercy Hospital 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.