CMS Price Transparency Data

Blood transfusion

Facility: City of Hope National Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $852
Cash Discount Price: $1,028
vs. Medicare Baseline: 1.89x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at City of Hope National Medical Center is $852. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,028. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.89x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$1,028

Average discount available for prompt cash payment at this facility.

Insurance Median

$852

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: $1,028 (228%)

Insurance Median: $852 (189%)

Cash: $1,028 (228% of Medicare)

Ins. Median: $852 (189% 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
Health Net	$39 - $1,236	9%
Cal Optima	$49	11%
Heritage Provider Network	$62 - $738	14%
Inland Empire	$62 - $844	14%
Prime Healthcare Keenan	$86 - $1,013	19%
Blue Cross Blue Shield	$477 - $2,110	106%
UnitedHealthcare	$535 - $929	119%
Blue Shield	$565 - $1,258	125%
Blue Shield Covca	$580 - $641	129%
Blue Shield Promise	$668 - $738	148%
Cencal	$764 - $844	170%
La Care Health	$764 - $844	170%
Kaiser	$859 - $950	191%
Aetna	$954 - $1,055	212%
Gold Coast	$954 - $1,055	212%
Molina	$954 - $1,372	212%
Cigna	$1,025 - $1,133	227%
Facey	$1,050 - $1,160	233%
Healthcare Partners	$1,107 - $1,224	246%
St. Joseph Heritage	$1,145 - $1,266	254%
Primecare Medical Network	$1,241 - $1,372	275%
First Health	$1,470 - $1,625	326%
Phcs Multiplan	$1,718 - $1,899	381%

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 $1,028.
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 City of Hope National 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.