CMS Price Transparency Data

Blood transfusion

Facility: Adventist Health Reedley

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,401
Cash Discount Price: $478
vs. Medicare Baseline: 3.11x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Adventist Health Reedley is $1,401. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $478. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.11x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.

Cash / Self-Pay

$478

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,401

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: $478 (106%)

Insurance Median: $1,401 (311%)

Cash: $478 (106% of Medicare)

Ins. Median: $1,401 (311% 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 311% of the Medicare baseline (a markup of 211%). 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	$27	6%
Blue Shield Mcare	$567	126%
Dignity Mcr Adv Op/Profee Only	$567	126%
Fhcn Pace Mcr Adv-All Plans	$567	126%
Healthnet- Mcr Adv	$567	126%
Kaiser Mcr Adv	$567	126%
Phs Prime Health Srvcs	$567	126%
Tricare	$567	126%
UnitedHealthcare	$567 - $1,387	126%
Bright Health Mcr Adv - All Plans	$891	198%
Aetna	$936 - $1,556	208%
Healthnet- All Other Plans	$947 - $1,242	210%
Western Growers/Pinnacle- All Plans	$1,001 - $1,313	222%
Ah Employee Health Plan - All Plans	$1,021	227%
Kaiser - All Other Plans	$1,088 - $1,428	241%
Blue Shield Epn - All Other Plans	$1,180 - $1,547	262%
Blue Shield Non Epn	$1,361 - $1,784	302%
Cigna	$1,415 - $1,856	314%
Physicians Med Group Op/Profee Only- All Plans	$1,742 - $2,284	386%
Cal Viva Hlth Mcal - All Plans	$2,177 - $2,855	483%
Kern Health Systems Mcal-All Plans	$2,177 - $2,855	483%
Medi-Cal	$2,177 - $2,855	483%
Dignity Mcal Op/Profee Only-All Other Plans	$2,395 - $3,140	531%
Healthnet Medi-Cal	$2,593 - $3,400	575%
Community Care Ipa Mcal-All Plans	$2,830 - $3,712	628%
Blue Cross Blue Shield	$5,138 - $6,903	1140%

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 $478.
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 Reedley 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.