CMS Price Transparency Data

Blood transfusion

Facility: Adventist Health Ukiah Valley

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,282
Cash Discount Price: $322
vs. Medicare Baseline: 2.84x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Adventist Health Ukiah Valley is $1,282. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $322. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.84x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$322

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,282

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: $322 (71%)

Insurance Median: $1,282 (284%)

Cash: $322 (71% of Medicare)

Ins. Median: $1,282 (284% 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 284% of the Medicare baseline (a markup of 184%). 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 Mcr Adv	$608	135%
Kaiser Mcr Adv	$608	135%
Tricare	$608	135%
UnitedHealthcare	$608 - $1,347	135%
Blue Shield Epn-All Other Plans	$614	136%
Blue Shield Non-Epn	$622	138%
Western Growers-All Plans	$918	204%
Healthnet-All Plans	$921	204%
Mendocino Lcc District-All Plans	$1,047	232%
Aetna	$1,068	237%
Ah Employee Health Plan - All Plans	$1,094	243%
Foundation For Medical Care-All Plans	$1,208	268%
Cigna	$1,257	279%
Kaiser-All Other Plans	$1,289	286%
Networks By Design-All Plans	$1,289	286%
Phcs Multiplan-All Plans	$1,289	286%
Interplan-All Plans	$1,321	293%
Beech Street-All Plans	$1,369	304%
Choice Care-All Plans	$1,369	304%
Health Mgmt Network-All Plans	$1,369	304%
Three Rivers-All Plans	$1,450	322%
Kaiser Medi-Cal	$1,611	357%
Medi-Cal	$1,611	357%
Blue Cross Blue Shield	$4,635 - $6,302	1028%

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 $322.
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 Ukiah Valley 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.