CMS Price Transparency Data

Blood transfusion

Facility: Valley Presbyterian Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,236
Cash Discount Price: $2,013
vs. Medicare Baseline: 2.74x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Valley Presbyterian Hospital is $1,236. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,013. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.74x the Medicare baseline. Located in 15107 Vanowen St, Van Nuys, CA.

Cash / Self-Pay

$2,013

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,236

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: $2,013 (447%)

Insurance Median: $1,236 (274%)

Cash: $2,013 (447% of Medicare)

Ins. Median: $1,236 (274% 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 274% of the Medicare baseline (a markup of 174%). 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 Promise Medi-Cal	$378 - $622	84%
Blue Shield Senior	$544	121%
Aetna	$555 - $1,642	123%
Blue Cross Blue Shield	$555 - $1,514	123%
Health Net Senior	$555	123%
La Care Covered California	$555	123%
Medicare (plans)	$555 - $583	123%
Blue Shield Ifp	$644	143%
Blue Shield	$773	171%
Ambetter / Centene	$783	174%
Heritage Provider Network (Regal & Lakeside)	$861 - $889	191%
La Care Medi-Cal	$907 - $1,493	201%
Phcs	$907 - $1,493	201%
Coventry Health Care (Ccn)	$1,058 - $1,742	235%
UnitedHealthcare	$1,078 - $1,936	239%
Health Net	$1,098	244%
Beech Street	$1,134 - $1,866	252%
Multiplan	$1,361 - $2,239	302%
Cigna	$1,766	392%

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 $2,013.
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 Valley Presbyterian 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.