CMS Price Transparency Data

Blood transfusion

Facility: San Antonio Regional Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $980
  • Cash Discount Price: $621
  • vs. Medicare Baseline: 2.17x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at San Antonio Regional Hospital is $980. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $621. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.17x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$621

Average discount available for prompt cash payment at this facility.

Insurance Median
$980

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: $621 (138%)
Insurance Median: $980 (217%)
Cash: $621 (138% of Medicare)
Ins. Median: $980 (217% 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 217% of the Medicare baseline (a markup of 117%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Ambetter / Centene $320 71%
Blue Shield Epn $525 116%
Epic Health Plan - All Other Plans $527 117%
Tricare $556 123%
Blue Shield Mcr Adv $567 126%
Caremore Mcr Adv - All Plans $567 126%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $567 126%
Healthnet Mcr Adv $567 126%
Humana $567 126%
Iehp Mcr Adv $567 126%
Inter Valley Hp Mcr Adv- All Plans $567 126%
Kindred Mcr Adv-All Plans $567 126%
Molina Mcr Adv $567 126%
Scan Health Plan Mcr Adv-All Plans $567 126%
Universal Care - All Plans $567 126%
Blue Cross Blue Shield $579 - $2,073 128%
Zelis Mcr Adv $596 132%
UnitedHealthcare $604 - $671 134%
Kasiser Mcr Adv $607 135%
Imperial Health Mcr Adv-All Plans $624 138%
Blue Shield Hmo Pos / Calpers Ppo $634 141%
Blue Shield Epo Ppo - All Other Plans $682 151%
Choice Phycn Ntwrk Op Only $709 157%
Molina Exchange-All Other Plans $738 164%
Aetna $766 - $1,757 170%
Iehp Comm - All Other Plans $823 183%
Redlands Employee $851 189%
Pc Inland Valley Scan $878 195%
Pc Inland Valley-All Other Plans $878 195%
Redlands Hmo-All Other Plans $885 196%
Cigna $933 207%
Coventry Ccn/First Hlth - All Plans $966 214%
Prime Health - All Plans $993 220%
Multiplan/Phcs - All Plans $1,265 281%
Networks By Design - All Plans $1,318 292%
Zelis Comm-All Other Plans $1,318 292%
Healthnet - All Other Plans $1,358 301%
Foundation Inland Epo-All Other Plans $1,406 312%
Foundation Inland Ppo $1,493 331%
Health Payors - All Plans $1,581 351%
Interplan - All Plans $1,581 351%
Kaiser Comm - All Other Plans $1,583 351%
Wellcare/Easy Choice-All Plans $1,722 382%
Alpha Care Mg Mcr Adv $1,757 390%
Central Hlth Plan Mcr Adv-All Plans $1,757 390%
Choicecare Ntwrk-All Plans $1,757 390%
Epic Health Plan Mcr Adv $1,757 390%
Medi-Cal $1,757 390%
Prospect Hp-All Plans $1,757 390%
Providence Clevercare Mcr Adv $1,757 390%
Heritage Prov Ntwrk/Regal Mcr Adv $1,783 396%
Clever Care Mcr Adv - All Plans $1,845 409%
Kaiser Medi-Cal $1,845 409%
La Salle Hp Mcr Adv-All Plans $1,845 409%
Healthnet Medi-Cal $1,854 411%
Alpha Care Mg Mcal/Hlthy Kids $1,933 429%
Heritage Prov Ntwrk/Regal Mcal $1,933 429%
Molina Medi-Cal $2,021 448%
Alpha Care Mg-All Other Plans $2,196 487%
Iehp Mcal $2,284 507%
Providence Oscar-All Other Plans $2,548 565%
Heritage Prov Ntwrk/Regal - All Other Plans $3,228 716%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals