CMS Price Transparency Data

Blood transfusion

Facility: Marinhealth Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $3,637
Cash Discount Price: $2,365
vs. Medicare Baseline: 8.07x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Marinhealth Medical Center is $3,637. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,365. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 8.07x the Medicare baseline. Located in 250 Bon Air Road, Greenbrae, CA.

Cash / Self-Pay

$2,365

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,637

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: $2,365 (525%)

Insurance Median: $3,637 (807%)

Cash: $2,365 (525% of Medicare)

Ins. Median: $3,637 (807% 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 807% of the Medicare baseline (a markup of 707%). 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
Aetna	$623 - $8,430	138%
Brown And Tolan	$623	138%
Healthnet Tailored Network	$623	138%
Kaiser	$623	138%
Marin Cancer Care	$623	138%
Ca Prison Health Care Services	$996	221%
Healthnet Enhancedcare	$1,619	359%
UnitedHealthcare	$2,330	517%
Provider Network Of America	$2,958	656%
Canopy	$3,580	794%
Canopy Hill Physicians	$3,580	794%
Blue Shield Cpic/Epo	$3,693	819%
Providers Network Of America	$3,923	870%
Blue Shield Hmo/Ppo	$4,104	911%
Hills Blue Shield Hmo/Ppo	$4,104	911%
Healthnet Hmo/Ppo	$4,153	921%
Healthnet Hmo/Ppo Hill Physicians	$4,153	921%
Blue Cross Blue Shield	$4,195 - $5,304	931%
Blue Shield Aco	$4,254	944%
Cigna	$7,820	1735%

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 $2,365.
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 Marinhealth 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.