CMS Price Transparency Data

Blood transfusion

Facility: Lompoc Valley Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $681
Cash Discount Price: $1,208
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Lompoc Valley Medical Center is $681. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,208. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.51x the Medicare baseline. Located in 1515 E Ocean Avenue, Lompoc, CA.

Cash / Self-Pay

$1,208

Average discount available for prompt cash payment at this facility.

Insurance Median

$681

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: $1,208 (268%)

Insurance Median: $681 (151%)

Cash: $1,208 (268% of Medicare)

Ins. Median: $681 (151% 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
Aetna	$567 - $1,739	126%
Blue Cross Blue Shield	$567 - $2,415	126%
Blue_Shield	$567	126%
Coventry	$567 - $1,739	126%
Health_Net	$567	126%
Humana	$567	126%
Medicare (plans)	$567	126%
Sansum	$567	126%
UnitedHealthcare	$567 - $1,690	126%
Work_Comp	$681	151%
Magellan	$1,449	321%
Blue_Shield_National	$1,910	424%
Cigna	$2,029	450%
Medi_Cal	$2,415	536%
Tricare	$2,415	536%

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 $1,208.
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 Lompoc Valley 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.