CMS Price Transparency Data

Blood transfusion

Facility: Adventist Health and Rideout

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,921
Cash Discount Price: $754
vs. Medicare Baseline: 6.48x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Adventist Health and Rideout is $2,921. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $754. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 6.48x the Medicare baseline. Located in 726 4Th St, Marysville, CA.

Cash / Self-Pay

$754

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,921

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: $754 (167%)

Insurance Median: $2,921 (648%)

Cash: $754 (167% of Medicare)

Ins. Median: $2,921 (648% 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 648% of the Medicare baseline (a markup of 548%). 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
Bc Mcal	$22	5%
Kaiser Mcr Adv	$569	126%
Tricare	$569	126%
UnitedHealthcare	$569 - $2,977	126%
Blue Cross Blue Shield	$575 - $2,639	128%
Ah Employee Health Plan - All Plans	$1,025	227%
Aetna	$2,423	538%
Healthnet Comm-All Other Plans	$2,495	554%
Kaiser-All Other Plans	$2,605	578%
Blue Shield Uc Care Members	$2,742	608%
Cigna	$2,921	648%
First Health-All Plans	$2,999	665%
Phcs-All Plans	$3,016	669%
Interplan-All Plans	$3,084	684%
Blue Shield-All Other Plans	$3,256	722%
Multiplan-All Plans	$3,256	722%
Healthnet Mcal	$3,427	760%
Kaiser Mcal	$3,427	760%
Medi-Cal	$3,427	760%
Ca Health And Wellness- All Plans	$4,249	943%
Celtic Mcaid-All Plans	$4,249	943%
Partnership Hp Mcal -All Plans	$5,655	1255%

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 $754.
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 Adventist Health and Rideout 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.