CMS Price Transparency Data

Blood transfusion

Facility: Providence Holy Cross Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $993
Cash Discount Price: $290
vs. Medicare Baseline: 2.20x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Providence Holy Cross Medical Center is $993. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $290. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.20x the Medicare baseline. Located in 15031 Rinaldi St, Mission Hills, CA.

Cash / Self-Pay

$290

Average discount available for prompt cash payment at this facility.

Insurance Median

$993

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: $290 (64%)

Insurance Median: $993 (220%)

Cash: $290 (64% of Medicare)

Ins. Median: $993 (220% 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 220% of the Medicare baseline (a markup of 120%). 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	$353 - $993	78%
Aetna	$567	126%
Humana	$579	128%
Blue Cross Blue Shield	$594 - $2,716	132%
Central Health Plan	$624	138%
La Care Health Plan	$738	164%
Healthnet	$1,050 - $2,391	233%
UnitedHealthcare	$1,528 - $1,738	339%
Cigna	$2,589	574%

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 $290.
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 Providence Holy Cross 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.