Blood transfusion
Facility: Lindsborg Community Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $511
- Cash Discount Price: $553
- vs. Medicare Baseline: 1.13x 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 |
|---|---|---|
| Tricare | $218 - $524 | 48% |
| Coventry Mcr Adv | $220 - $530 | 49% |
| Cigna | $393 - $949 | 87% |
| UnitedHealthcare | $417 - $1,004 | 93% |
| Coventry Comm-All Other Plans | $417 - $1,004 | 93% |
| Phcs Preferred-All Plans | $430 - $1,038 | 95% |
| Multiplan-All Plans | $430 - $1,038 | 95% |
| Century Health-All Plans | $440 - $1,060 | 98% |
| Health Partners -All Plans | $440 - $1,060 | 98% |
| Wppa-All Plans | $440 - $1,060 | 98% |
| Coventry Wc | $440 - $1,060 | 98% |
| Blue Cross Blue Shield | $511 | 113% |
Consumer Guidance & Cost Commentary
For the CPT code 36430, representing a blood transfusion, the cash median price at Lindsborg Community Hospital is $553.00, while the median negotiated rate across 12 payers is $511.00. This service is provided at a Critical Access Hospital in Lindsborg, KS, with a gross chargemaster of $789.00. When comparing these rates to the national benchmark, the facility's cash price is 1.1 times the Medicare amount of $450.73. For patients with high-deductible plans, paying the cash median of $553.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates for major carriers like Cigna and UnitedHealthcare range from $393 to $1,004, often exceeding the cash price. Patients should explicitly ask the hospital about self-pay or prompt-pay discounts before scheduling, as paying in full within a short window can sometimes reduce the final bill by 20% to 50%.
It is important to understand that commercial insurance rates are often inflated by administrative costs and contract structures, which can make them higher than the cash price despite being "in-network." While the No Surprises Act protects patients from balance billing for emergency care at in-network facilities, unexpected ancillary services or out-of-network providers could still trigger additional charges if not carefully reviewed. To avoid surprise costs, patients should request a full itemized bill before paying, ensuring no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. If a balance bill is received, patients should dispute