Blood transfusion
Facility: Wamego Health Center
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $235
- Cash Discount Price: $330
- vs. Medicare Baseline: 0.52x 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 |
|---|---|---|
| Providrs Care | $44 | 10% |
| UnitedHealthcare | $225 | 50% |
| Aetna | $234 | 52% |
| Medicaid / KanCare | $234 - $236 | 52% |
| Tricare | $260 | 58% |
| Blue Cross Blue Shield | $677 - $713 | 150% |
| Medica | $750 | 166% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Wamego Health Center in Wamego, KS, the facility's cash median price is $330.00, which is lower than the facility's negotiated rates with major payers like Blue Cross Blue Shield ($677–$713) and Medica ($750). While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance contracts often result in higher allowed amounts than self-pay options. The cash price of $330.00 is significantly lower than the Medicare benchmark of $450.73, suggesting that paying out-of-pocket may be the most cost-effective option for individuals with high-deductible plans or those without insurance coverage.
To ensure you are receiving the best possible rate, it is recommended to request an itemized bill before finalizing payment, as summary bills can obscure specific charges or unbundled components. If you choose to use insurance, note that the negotiated rates range from $225 to $750 depending on the payer, with Medicaid/KanCare plans showing a range of $234 to $236 across three plans. Patients should explicitly ask the billing department about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if paid upfront, and verify that no balance billing will occur for out-of-network ancillary services under federal protections. Always confirm your deductible status before scheduling, as paying the negotiated rate without meeting your deductible may result in higher out-of-pocket expenses than the cash price.