CMS Price Transparency Data

Blood transfusion

Facility: Grossmont Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,683
Cash Discount Price: $3,493
vs. Medicare Baseline: 5.95x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Grossmont Hospital is $2,683. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,493. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 5.95x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$3,493

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,683

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: $3,493 (775%)

Insurance Median: $2,683 (595%)

Cash: $3,493 (775% of Medicare)

Ins. Median: $2,683 (595% 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 595% of the Medicare baseline (a markup of 495%). 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
Humana	$5 - $2,577	1%
Health Net	$68 - $3,563	15%
Medicare (plans)	$68 - $3,563	15%
Aetna	$129 - $6,052	29%
Kaiser	$448 - $3,563	99%
Blue Cross Blue Shield	$626 - $4,756	139%
Cigna	$634 - $4,632	141%
County Medical Services	$837 - $2,958	186%
Blue Shield	$926 - $3,563	205%
Allianz Global Assistance	$1,016 - $4,140	225%
Epic Americas	$1,016 - $1,255	225%
Interplan	$1,255 - $4,097	278%
Molina	$1,255 - $4,941	278%
Community Health Group	$1,436 - $4,756	319%
Medi-Cal	$1,436 - $4,323	319%
Multiplan	$1,436 - $3,397	319%
San Diego Pace	$1,494 - $3,169	331%
Indian Health Council	$1,664 - $2,696	369%
UnitedHealthcare	$2,017 - $4,097	447%
California Health And Wellness	$2,092 - $3,253	464%
Managed Health Network	$2,594 - $3,767	576%

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 $3,493.
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 Grossmont 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.