CMS Price Transparency Data

Blood transfusion

Facility: Good Samaritan Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,352
Cash Discount Price: $4,305
vs. Medicare Baseline: 3.00x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Good Samaritan Hospital is $1,352. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,305. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.00x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.

Cash / Self-Pay

$4,305

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,352

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: $4,305 (955%)

Insurance Median: $1,352 (300%)

Cash: $4,305 (955% of Medicare)

Ins. Median: $1,352 (300% 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 300% of the Medicare baseline (a markup of 200%). 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
Santa Clara Family Health Plan	$321 - $1,275	71%
Bright Health	$340 - $3,498	75%
Aetna	$352 - $7,317	78%
Cigna	$393 - $3,859	87%
Health Net	$394 - $1,111	87%
United	$431 - $2,686	96%
Blue Shield	$501 - $2,239	111%
Medcare Partners	$649	144%
Santa Clara Ipa Comm	$845 - $2,385	187%
Santa Clara Ipa Mcr	$845 - $2,385	187%
Nx Health Network	$1,014 - $2,862	225%
Sutter Select	$1,014 - $2,862	225%
Multiplan	$1,098 - $3,816	244%
Humana	$1,183 - $3,339	262%
First Health	$1,284 - $4,770	285%
Healthsmart	$1,352 - $4,054	300%
Intercontinental Corporation	$1,352 - $3,816	300%
Pha Pacific Health Alliance	$1,352 - $3,816	300%
Ppo Next	$1,352 - $3,816	300%
Blue Cross Blue Shield	$4,758 - $5,022	1056%

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 $4,305.
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 Good Samaritan Hospital 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.