CMS Price Transparency Data
Blood transfusion
Facility: Greater El Monte Community Hospital
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $642
- Cash Discount Price: $1,200
- vs. Medicare Baseline: 1.42x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Greater El Monte Community Hospital is $642. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,200. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.42x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$1,200
Average discount available for prompt cash payment at this facility.
Insurance Median
$642
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: $1,200 (266%)
Insurance Median: $642 (142%)
Cash: $1,200 (266% of Medicare)
Ins. Median: $642 (142% 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.
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 |
|---|---|---|
| In Custody-Ca Highway Patrol | $20 | 4% |
| Care 1St Medi Cal Hmo Cap Exceptional Care | $120 | 27% |
| Care First Health Plan | $120 | 27% |
| Clinica Medica Familiar | $144 - $600 | 32% |
| Bella Vista Medical Group Ipa | $240 - $540 | 53% |
| Global Care Medical Group Ipa | $240 - $540 | 53% |
| Alta Med Health Services Med Grp | $300 | 67% |
| Ahmc Reciprocity Agreement | $360 | 80% |
| Ahmc Reciprocity Agreement Senior/Commercial | $360 | 80% |
| Allied Physicians Medical Group | $360 | 80% |
| Good Samaritan Medical Practice Assoc | $360 - $720 | 80% |
| Lincoln Hospital Medical Center | $360 | 80% |
| Veterans Administration | $397 | 88% |
| Molina Healthcare Of California | $468 - $709 | 104% |
| Blue Cross Blue Shield | $505 - $1,256 | 112% |
| Associated Hispanic Physicians | $511 | 113% |
| Aids Health Foundation | $558 | 124% |
| Altamed Health Network | $558 | 124% |
| Apa/Aco Inc | $558 | 124% |
| Avanti | $558 - $681 | 124% |
| Beverly Hospital | $558 - $624 | 124% |
| Blue Shield Of California | $558 - $1,200 | 124% |
| Brand New Day | $558 - $709 | 124% |
| Cms | $558 | 124% |
| Easy Choice Health Plan | $558 | 124% |
| Health Net Inc | $558 - $1,425 | 124% |
| La Care Health Plan | $558 - $660 | 124% |
| Other Non Contracted Senior Hmo | $558 | 124% |
| Pacific Alliance Medical Center Reciprocal Contract | $558 | 124% |
| Scan Health Plan | $558 | 124% |
| UnitedHealthcare | $558 - $1,030 | 124% |
| Champus Foundation | $567 | 126% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $567 | 126% |
| Emanate Health | $567 - $709 | 126% |
| Health Net Foundation | $567 - $1,299 | 126% |
| La Care Covered Direct | $567 | 126% |
| Pacificare Of California | $567 - $1,039 | 126% |
| Self-Pay | $567 | 126% |
| Alignment Health Plan | $586 | 130% |
| Molina Healthcare | $586 | 130% |
| Inter Valley Health Plan | $596 | 132% |
| California Thoroughbred Horesmans Foundation | $600 | 133% |
| Universal Care | $600 - $840 | 133% |
| Cigna | $612 | 136% |
| San Miguel Health Plan | $624 | 138% |
| Chinatown Service Center Pace | $670 | 149% |
| Intercomp | $679 | 151% |
| Ahmc Health Self-Insurance Epo | $709 | 157% |
| Knox-Keene Act | $709 | 157% |
| Preferred Health Network | $717 | 159% |
| Care 1St Health Plan | $720 | 160% |
| Employee Health Systems Medical Group | $720 | 160% |
| Interplan | $732 - $900 | 162% |
| Athens Administrators | $755 | 168% |
| Multiplan | $755 - $1,020 | 168% |
| Other Non Contracted Work Comp | $755 | 168% |
| Cost Containment Strategies | $780 | 173% |
| In Custody Police Dept | $780 | 173% |
| Central Health Plan | $840 | 186% |
| Community Care Network | $960 | 213% |
| Health Payors Organization | $1,080 | 240% |
| Commercial Non Contract | $1,200 | 266% |
| Medi-Cal Sub Acute | $1,200 | 266% |
| Nuclear Medicine/Whmc | $1,200 | 266% |
| One Legacy | $1,200 | 266% |