CMS Price Transparency Data

Blood transfusion

Facility: Sharp Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,556
Cash Discount Price: $3,493
vs. Medicare Baseline: 5.67x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Sharp Memorial Hospital is $2,556. 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 5.67x the Medicare baseline. Located in 7901 Frost St, San Diego, CA.

Cash / Self-Pay

$3,493

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,556

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: $2,556 (567%)

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

Ins. Median: $2,556 (567% 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 567% of the Medicare baseline (a markup of 467%). 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
Blue Shield	$189 - $2,577	42%
Health Net	$189 - $4,941	42%
Interplan	$725	161%
Molina	$764 - $4,138	170%
Cigna	$1,425 - $3,380	316%
Aetna	$1,436 - $4,323	319%
Indian Health Council	$1,729 - $4,323	384%
UnitedHealthcare	$1,731 - $4,632	384%
Kaiser	$1,793 - $4,323	398%
Blue Cross Blue Shield	$2,324 - $3,380	516%
Humana	$2,387	530%
Medi-Cal	$2,577 - $2,876	572%
Multiplan	$2,958	656%
San Diego Pace	$3,461 - $4,051	768%
Community Health Group	$3,464	769%
Allianz Global Assistance	$3,818	847%

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 Sharp Memorial 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.