CMS Price Transparency Data

Blood transfusion

Facility: St Rose Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $627
Cash Discount Price: $459
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at St Rose Hospital is $627. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $459. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.39x the Medicare baseline. Located in 27200 Calaroga Ave, Hayward, CA.

Cash / Self-Pay

$459

Average discount available for prompt cash payment at this facility.

Insurance Median

$627

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: $459 (102%)

Insurance Median: $627 (139%)

Cash: $459 (102% of Medicare)

Ins. Median: $627 (139% 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
Aetna	$43 - $1,072	10%
Cigna	$46 - $1,149	10%
Healthnet Of California	$46 - $1,072	10%
UnitedHealthcare	$46 - $1,225	10%
Centers For Elder Independence	$596	132%
Brown & Toland	$627	139%
Humana	$627	139%
Imperial Health Senior	$627	139%
Medicare (plans)	$627	139%
Interplan	$1,072	238%
Multiplan Inc	$1,179	262%
Canopy	$1,192	264%
Kaiser Foundation Hospitals	$1,225	272%
Preferred Health Network	$1,302	289%
Blue Shield	$1,568	348%
Blue Shield Affinity	$1,568	348%
Blue Shield Hill	$1,568	348%

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 $459.
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 St Rose 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.