CMS Price Transparency Data
Blood transfusion
Facility: Garfield Medical Center
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $997
- Cash Discount Price: $2,435
- vs. Medicare Baseline: 2.21x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Garfield Medical Center is $997. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,435. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.21x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$2,435
Average discount available for prompt cash payment at this facility.
Insurance Median
$997
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: $2,435 (540%)
Insurance Median: $997 (221%)
Cash: $2,435 (540% of Medicare)
Ins. Median: $997 (221% 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 221% of the Medicare baseline (a markup of 121%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Molina Medical Group | $55 - $812 | 12% |
| Alignment Health Plan | $70 - $586 | 16% |
| Pacific Independent Physician Association | $167 - $446 | 37% |
| Access Ipa Ancillary | $208 - $836 | 46% |
| Associated Hispanic Phys Of So Cal | $208 - $557 | 46% |
| Care First Health Plan | $208 - $279 | 46% |
| UnitedHealthcare | $208 - $1,723 | 46% |
| Ucla Impact Dept Of Uncology | $222 | 49% |
| Aetna | $365 - $4,056 | 81% |
| Veterans Administration | $397 | 88% |
| Family Health Alliance | $500 - $836 | 111% |
| Avanti | $511 - $681 | 113% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $511 | 113% |
| Hollywood Presbyterian Medpoint Mcal | $511 | 113% |
| Ahmc Healthcare Inc | $558 - $625 | 124% |
| Aids Health Foundation | $558 | 124% |
| Allied Physicians Risk Pool Agreement | $558 - $729 | 124% |
| Apa Aco Inc | $558 | 124% |
| Beverly Hospital | $558 - $624 | 124% |
| Blue Cross Blue Shield | $558 - $2,786 | 124% |
| Blue Shield | $558 - $2,083 | 124% |
| Central Health Plan | $558 - $1,020 | 124% |
| Cms | $558 | 124% |
| Easy Choice Health Plan | $558 | 124% |
| Health Net | $558 - $1,794 | 124% |
| Humana | $558 | 124% |
| La Care Health Plan | $558 - $1,532 | 124% |
| Non-Contract Medi-Care | $558 | 124% |
| Pacific Alliance Medical Center Comm/Sr | $558 | 124% |
| Physicians Healthways Medical Corporation | $558 - $2,786 | 124% |
| Advantage Care Ipa | $567 - $2,786 | 126% |
| Allied Physicians | $567 - $851 | 126% |
| Allied Physicians Risk Pool | $567 - $729 | 126% |
| Blue Shield Of California | $567 - $2,083 | 126% |
| Brand New Day | $567 - $709 | 126% |
| Cv-19 Hrsa Uninsured Testing And Tx | $567 | 126% |
| Emanate Health | $567 - $709 | 126% |
| First Health Network | $567 - $1,950 | 126% |
| La Care Covered Direct | $567 | 126% |
| Scan Health Plan Sr Hmo | $567 | 126% |
| Self-Pay | $567 | 126% |
| Molina Healthcare | $586 | 130% |
| Molina Healthcare Of California | $586 - $709 | 130% |
| Inter Valley Health Plan | $596 | 132% |
| National Disaster Medical System | $624 | 138% |
| San Miguel Health Plan | $624 | 138% |
| Chinatown Service Center Pace | $681 | 151% |
| Ahmc Health Epo | $709 | 157% |
| Knox-Keene Act | $709 | 157% |
| Preferred Health Network | $717 | 159% |
| Healthnet Medi Cal Cap | $729 - $975 | 162% |
| Pipa Risk Pool Agreement | $729 - $975 | 162% |
| Interplan | $732 - $2,090 | 162% |
| Athens Administrators | $755 | 168% |
| Multiplan | $755 - $2,368 | 168% |
| Other Non-Contracted Workers Compensation | $755 | 168% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $833 - $1,114 | 185% |
| Health Net Foundation M Cal (Family Health Alliance) | $833 - $1,114 | 185% |
| Phys Assoc Of San Gab Valley | $833 - $1,114 | 185% |
| Pacificare Ppo | $855 - $1,473 | 190% |
| Health Net Comm/Hmo | $902 - $1,532 | 200% |
| Health Net Inc | $921 | 204% |
| Allied Physicians Med Grp | $1,042 - $1,393 | 231% |
| Cigna | $1,062 - $1,588 | 236% |
| Pacificare Of California Inc | $1,209 - $2,060 | 268% |
| Alhambra Hospital | $1,250 - $1,300 | 277% |
| Care 1St Health Plan | $1,250 - $1,672 | 277% |
| Employee Health Systems Mg | $1,250 - $1,672 | 277% |
| One Health Plan | $1,458 - $1,600 | 323% |
| Fmc Los Angeles Co Epo | $1,562 - $2,090 | 347% |
| Corvel Corporation | $1,666 - $2,229 | 370% |
| Americas Health Plan | $1,771 - $2,368 | 393% |
| Health Payors Organization | $1,875 - $2,507 | 416% |
| East La Reg Ctr | $2,083 - $2,786 | 462% |
| Non Contract Commercial | $2,083 - $2,786 | 462% |
| One Legacy | $2,083 - $2,786 | 462% |
| Physicians Healthways Medi-Cal | $2,083 - $2,786 | 462% |
| Private Pay | $2,083 - $2,786 | 462% |