CMS Price Transparency Data

Blood transfusion

Facility: Memorialcare Saddleback Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,300
Cash Discount Price: $5,192
vs. Medicare Baseline: 2.88x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Memorialcare Saddleback Medical Center is $1,300. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,192. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.88x the Medicare baseline. Located in 24451 Health Center Drive, Laguna Hills, CA.

Cash / Self-Pay

$5,192

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,300

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: $5,192 (1152%)

Insurance Median: $1,300 (288%)

Cash: $5,192 (1152% of Medicare)

Ins. Median: $1,300 (288% 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 288% of the Medicare baseline (a markup of 188%). 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
Select Health	$369 - $766	82%
Seoul Medical Group	$511	113%
Blue Shield	$556 - $1,618	123%
Aetna	$567 - $4,134	126%
Blue Cross Blue Shield	$594 - $2,065	132%
Easy Choice	$596	132%
Central Health	$624	138%
Clever Care	$681	151%
Monarch Health Plan	$709 - $1,419	157%
UnitedHealthcare	$789 - $1,897	175%
Centivo	$1,277	283%
Healthnet	$2,044 - $2,920	453%
Cigna	$2,057 - $3,234	456%

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 $5,192.
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 Memorialcare Saddleback 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.