CMS Price Transparency Data

Blood transfusion

Facility: UCSF Health St. Mary's Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,990
Cash Discount Price: $2,490
vs. Medicare Baseline: 4.42x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at UCSF Health St. Mary's Hospital is $1,990. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,490. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 4.42x the Medicare baseline. Located in 450 Stanyan St, San Francisco, CA.

Cash / Self-Pay

$2,490

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,990

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: $2,490 (552%)

Insurance Median: $1,990 (442%)

Cash: $2,490 (552% of Medicare)

Ins. Median: $1,990 (442% 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 442% of the Medicare baseline (a markup of 342%). 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
Brown Toland	$49 - $642	11%
Aetna	$642	142%
Blue Cross Blue Shield	$642 - $3,152	142%
Blue Shield Ca	$642 - $1,815	142%
Chinese Community	$642 - $2,553	142%
Connected Care	$642	142%
Health Net	$642 - $9,457	142%
Health Plan San Mateo	$642	142%
Humana	$642	142%
Kaiser	$642 - $2,396	142%
Mhn	$642	142%
United	$642 - $3,152	142%
Magellan	$1,456 - $1,891	323%
Healthsmart	$1,699 - $2,206	377%
Kentfield	$1,862	413%
Multiplan	$2,014 - $2,616	447%
Oscar	$2,106	467%
Us Behavioral Health	$2,427 - $3,152	538%

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 $2,490.
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 UCSF Health St. Mary's 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.