CMS Price Transparency Data

Blood transfusion

Facility: El Centro Regional Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $840
Cash Discount Price: $1,049
vs. Medicare Baseline: 1.86x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at El Centro Regional Medical Center is $840. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,049. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.86x the Medicare baseline. Located in 1415 Ross Avenue, El Centro, CA.

Cash / Self-Pay

$1,049

Average discount available for prompt cash payment at this facility.

Insurance Median

$840

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: $1,049 (233%)

Insurance Median: $840 (186%)

Cash: $1,049 (233% of Medicare)

Ins. Median: $840 (186% 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	$566 - $993	126%
Brand New Day Comm - All Other Plans	$566	126%
Brand New Day Mcr	$566	126%
Healthnet Mcr Adv	$566	126%
Molina Mcr Adv	$566	126%
Scp Managed Care - All Plans	$566	126%
Tricare	$566	126%
UnitedHealthcare	$566 - $751	126%
Easy Choice Mcr Adv-All Plans	$623	138%
Aetna	$660	146%
Healthnet Hmo	$708	157%
Cdcr Correctional-All Plans	$736	163%
Blue Shield-All Plans	$750	166%
Pacificare-All Plans	$929	206%
Mulitplan Primary - All Other Plans	$1,019	226%
Cigna	$1,124	249%
Multiplan Comp	$1,199	266%
Trident - All Plans	$1,274	283%
Healthnet Comm-All Other Plans	$1,349	299%
Humana	$1,394	309%
Ahccs/Medi-Cal Misc - All Plans	$1,499	333%
Brand New Day Mcal	$1,499	333%
Medi-Cal	$1,499	333%
Molina Exchange - All Other Plans	$1,499	333%
Ambetter / Centene	$1,544	343%
Molina Mcal	$1,649	366%

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 $1,049.
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 El Centro Regional Medical Center 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.