CMS Price Transparency Data

Blood transfusion

Facility: Loma Linda University Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $942
Cash Discount Price: $1,526
vs. Medicare Baseline: 2.09x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Loma Linda University Medical Center is $942. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,526. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.09x the Medicare baseline. Located in 11234 Anderson St, Loma Linda, CA.

Cash / Self-Pay

$1,526

Average discount available for prompt cash payment at this facility.

Insurance Median

$942

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: $1,526 (339%)

Insurance Median: $942 (209%)

Cash: $1,526 (339% of Medicare)

Ins. Median: $942 (209% 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 209% of the Medicare baseline (a markup of 109%). 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
Adventist Health	$400 - $1,390	89%
UnitedHealthcare	$440 - $1,696	98%
Alpha Care Medical Group	$555 - $833	123%
Dignity Health	$555 - $833	123%
Epic Health Plan	$555 - $1,356	123%
Inland Empire Health Plan (Iehp)	$555 - $973	123%
Kaiser Foundation Hospitals	$555 - $2,262	123%
Upland Medical Group	$555	123%
Vantage Medical Group	$555 - $833	123%
Prime Health Services	$589 - $2,882	131%
Riverside University Health System	$611	136%
Lluh Dept Of Risk Management	$678	150%
Molina Healthcare Of Ca	$744	165%
Blue Cross Blue Shield	$885 - $2,582	196%
Multiplan	$885 - $2,543	196%
Preferred Health Network	$903	200%
Heritage Provider Network	$911	202%
Blue Shield Of California	$1,353 - $2,072	300%
Global Benefits Group	$2,035	451%
Temecula Valley Physicians Medical Group	$2,035	451%
Trivalley Medical Group	$2,035	451%
Cigna	$2,170 - $2,509	481%
Networks By Design	$2,204	489%
Central Health Plan	$2,713	602%
Galaxy Health	$2,882	639%
Aetna	$2,901	644%
Health Management Network	$3,052	677%

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 $1,526.
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 Loma Linda University 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.