CMS Price Transparency Data

Blood transfusion

Facility: Oak Valley Hospital District

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $3,254
Cash Discount Price: $3,203
vs. Medicare Baseline: 7.22x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Oak Valley Hospital District is $3,254. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,203. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 7.22x the Medicare baseline. Located in 350 S Oak Ave, Oakdale, CA.

Cash / Self-Pay

$3,203

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,254

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: $3,203 (711%)

Insurance Median: $3,254 (722%)

Cash: $3,203 (711% of Medicare)

Ins. Median: $3,254 (722% 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 722% of the Medicare baseline (a markup of 622%). 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
Alignment Op Only Ip/Op Only-All Plans	$567	126%
Humana	$567	126%
Kaiser Mcr Adv Ip/Op Only	$567	126%
Scan Health Plan Ip/Op Only-All Plans	$579	128%
Imperial Health Ip/Op Only-All Plans	$624	138%
Healthnet Comm Op Only Ip/Op Only-All Other Plans	$881 - $3,558	195%
UnitedHealthcare	$896 - $3,618	199%
Kaiser Comm Ip/Op Only-All Other Plans	$926 - $3,739	205%
Cigna	$1,001 - $4,040	222%
Blue Cross Blue Shield	$1,046 - $6,030	232%
Blue Shield Epn Ip/Op Only	$1,138 - $4,595	252%
Aetna	$1,271 - $5,132	282%
Blue Shield/Bcout Ip/Op Only-All Other Plans	$1,345 - $5,427	298%
Healthnet Medi-Cal Ip/Op Only	$1,494 - $6,030	331%
Kaiser Medi-Cal Ip/Op Only	$1,494 - $6,030	331%
Medi-Cal Ip/Op Only	$1,494 - $6,030	331%
Hp Of San Joaquin Ip/Op Only-All Plans	$1,793 - $7,236	398%

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 $3,203.
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 Oak Valley Hospital District 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.