CMS Price Transparency Data

Blood transfusion

Facility: Menifee Global Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $1,426
  • Cash Discount Price: $1,965
  • vs. Medicare Baseline: 3.16x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Menifee Global Medical Center is $1,426. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,965. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.16x the Medicare baseline. Located in 28400 McCall Boulevard, Sun City, CA.
Cash / Self-Pay
$1,965

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,426

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: $1,965 (436%)
Insurance Median: $1,426 (316%)
Cash: $1,965 (436% of Medicare)
Ins. Median: $1,426 (316% 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 316% of the Medicare baseline (a markup of 216%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Tricare $44 - $4,460 10%
Health Net Enhanced Ppo $72 - $5,279 16%
Primecare Commercial $242 - $434 54%
Health Net Medi-Cal $356 - $14,700 79%
Altamed Mcal Hmo $363 - $15,000 81%
Altamed Mcal/Pace $363 - $15,000 81%
Molina Medi-Cal $363 - $15,000 81%
Velocity $545 - $6,599 121%
Aetna $565 - $3,771 125%
Altamed Comm Hmo (Ancillary) $565 - $3,771 125%
Altamed Health Services Senior $565 - $3,771 125%
Altamed Sr/Pace $565 - $3,771 125%
Blue Shield Senior $565 - $3,771 125%
Central Health Plan Senior $565 - $3,771 125%
Clever Care Health Plan Sr $565 - $3,771 125%
For Your Benefit Senior $565 - $3,771 125%
Guidant Health Plan Senior $565 - $3,771 125%
Health Net Senior $565 - $3,771 125%
Hpn Senior $565 - $3,771 125%
Humana $565 - $3,771 125%
Ic $565 - $3,671 125%
Kaiser Senior $565 - $3,771 125%
Lasalle Medical Assoc (Ancillary) Senior $565 - $3,771 125%
Managed Health Network Sr $565 - $3,771 125%
Medicare (plans) $565 - $3,771 125%
Neighborhood Healthcare Pace $565 - $3,771 125%
Primecare Senior $565 - $3,771 125%
Prospect Health Plan Sr Hmo $565 - $3,771 125%
Scan Senior $565 - $3,771 125%
Sr Capitation $565 - $3,771 125%
UnitedHealthcare $565 - $3,771 125%
Veterans Administration $565 - $3,771 125%
Imperial Health Plan Of Ca $567 - $3,771 126%
Lasalle Medical Assoc (Ancillary) Commercial $567 - $3,771 126%
Point Comfort Underwriters $567 - $3,771 126%
Self Pay/Ab774/Charity Discount $567 - $3,771 126%
Molina Covered Ca $578 - $4,510 128%
Cigna $626 - $1,736 139%
Align Senior Care $632 - $4,223 140%
Welbehealth Sr/Pace $632 - $4,223 140%
First Health Commercial $636 - $1,139 141%
Prime Health Services Senior $649 - $4,336 144%
Coventry $679 - $706 151%
Prime Health Services Wcomp $679 151%
Iehp Covered Ca $706 - $4,713 157%
Three Rivers Wcomp $740 164%
Workers Comp Non-Contracted $755 168%
Prospect Health Plan Comm Hmo $762 - $5,090 169%
Hpn Commercial/Covered Ca $790 - $5,279 175%
Health Net Comm $847 - $5,656 188%
Multiplan Ppo $848 - $1,519 188%
Multiplan Wcomp $848 - $1,519 188%
Pnoa-Provider Network Of America $969 - $1,736 215%
Prime Health Services Commercial $969 - $1,736 215%
Three Rivers Network $993 - $6,599 220%
Ava Hospice $1,211 - $2,170 269%
Kaiser Commercial $1,211 - $2,170 269%
Living Waters Hospice $1,211 - $2,170 269%
Managed Health Network $1,211 - $2,170 269%
Other Insurance Loa $1,211 - $2,170 269%
Pacific Valley Hospice $1,211 - $2,170 269%
Private Pay $1,211 - $2,170 269%
Silverado Hospice $1,211 - $2,170 269%
Vna Hospice $1,211 - $2,170 269%
Blue Shield Epn $1,587 - $10,595 352%
Blue Shield Commercial $1,869 - $12,481 415%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 28400 McCall Boulevard, Sun City, CA 92585
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals