CMS Price Transparency Data

Blood transfusion

Facility: Los Robles Hospital & Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,683
Cash Discount Price: $3,156
vs. Medicare Baseline: 5.95x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Los Robles Hospital & Medical Center is $2,683. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,156. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 5.95x the Medicare baseline. Located in 215 W Janss Rd, Thousand Oaks, CA.

Cash / Self-Pay

$3,156

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,683

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: $3,156 (700%)

Insurance Median: $2,683 (595%)

Cash: $3,156 (700% of Medicare)

Ins. Median: $2,683 (595% 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 595% of the Medicare baseline (a markup of 495%). 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	$559 - $7,918	124%
Medcare Partners	$567	126%
Cigna	$814 - $7,693	181%
Bright Health	$870 - $6,767	193%
United	$887 - $4,419	197%
Blue Shield	$889 - $4,768	197%
Health Net	$1,284	285%
First Health	$2,146 - $2,525	476%
Choicecare Network	$2,209	490%
Multiplan	$2,525 - $2,998	560%
Ppo Next	$2,525	560%
Interplan Corporation	$2,840	630%
Ventura County Foundation	$2,840	630%
Blue Cross Blue Shield	$6,240 - $6,585	1384%

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 $3,156.
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 Los Robles Hospital & 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.