CMS Price Transparency Data

Blood transfusion

Facility: Community Memorial Hospital - Ventura

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $555
Cash Discount Price: $720
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Community Memorial Hospital - Ventura is $555. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $720. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.23x the Medicare baseline. Located in 147 North Brent Street, Ventura, CA.

Cash / Self-Pay

$720

Average discount available for prompt cash payment at this facility.

Insurance Median

$555

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: $720 (160%)

Insurance Median: $555 (123%)

Cash: $720 (160% of Medicare)

Ins. Median: $555 (123% 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.

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
Seaview	$51	11%
Valley Care	$64 - $300	14%
Ventura County Health Care Plan	$300	67%
Gold Coast Health Plan	$420	93%
Medicaid / KanCare	$420	93%
Tricare	$528	117%
Aetna	$555 - $3,637	123%
Blue Cross Blue Shield	$555 - $1,688	123%
California Workers Compensation	$555	123%
Medicare (plans)	$555 - $567	123%
Non Contracted	$555	123%
Wellcare Of California	$555	123%
Alignment Health Plan	$567	126%
Humana	$567	126%
Scan Health Plan	$567	126%
UnitedHealthcare	$567 - $3,840	126%
Cigna	$660	146%
Multiplan	$720	160%
Kaiser Commercial	$1,114	247%
Blue Shield Commercial	$1,200	266%
Blue Shield Epn	$1,200	266%
Health Net Commercial	$1,200	266%

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 $720.
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 Community Memorial Hospital - Ventura 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.