CMS Price Transparency Data
Blood transfusion
Facility: Coastal Communities Hospital
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $1,824
- Cash Discount Price: $2,632
- vs. Medicare Baseline: 4.05x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Coastal Communities Hospital is $1,824. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,632. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 4.05x the Medicare baseline. Located in 2701 S Bristol St, Santa Ana, CA.
Cash / Self-Pay
$2,632
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,824
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: $2,632 (584%)
Insurance Median: $1,824 (405%)
Cash: $2,632 (584% of Medicare)
Ins. Median: $1,824 (405% 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 405% of the Medicare baseline (a markup of 305%). 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 |
|---|---|---|
| Monarch | $238 - $4,246 | 53% |
| Monarch Health Plan | $300 - $1,581 | 67% |
| UnitedHealthcare | $408 - $4,246 | 91% |
| Altamed Health Services | $536 - $15,000 | 119% |
| Champus | $545 - $4,604 | 121% |
| Blue Shield | $565 - $16,176 | 125% |
| Central Health Plan Of California | $565 - $4,246 | 125% |
| Champion Health Plan | $565 - $4,246 | 125% |
| Citizens Choice Health Plan | $565 - $4,246 | 125% |
| Clever Care Health Plan | $565 - $4,246 | 125% |
| Easy Choice Health Plan | $565 - $4,246 | 125% |
| For Your Benefit | $565 - $4,246 | 125% |
| Health Net | $565 - $7,319 | 125% |
| Healthcare Partners Sr Hmo | $565 - $4,246 | 125% |
| Heritage | $565 - $4,246 | 125% |
| Hollywood Presbyterian | $565 - $4,246 | 125% |
| Humana | $565 - $4,246 | 125% |
| Kaiser | $565 - $4,246 | 125% |
| Kpc Healthcare Inc | $565 - $15,000 | 125% |
| Onecare | $565 - $4,246 | 125% |
| Onecare Connect | $565 - $4,246 | 125% |
| Other Senior Non Contract | $565 - $4,246 | 125% |
| Prospect Health Plan | $565 - $6,369 | 125% |
| Scan Health Plan | $565 - $4,246 | 125% |
| Us Federal Marshall/Department Of Immigration | $565 - $4,246 | 125% |
| Velocity Provider Network Sr | $565 - $4,246 | 125% |
| Verda Health Plan Sr | $565 - $4,246 | 125% |
| Veterans Administration | $565 - $4,246 | 125% |
| Caloptima | $567 - $4,246 | 126% |
| Choice Physicians Network | $567 - $4,246 | 126% |
| Imperial Health Plan Of Ca | $567 - $4,246 | 126% |
| Innovative Integrated Health | $567 - $4,246 | 126% |
| Medcare Partners | $567 - $4,246 | 126% |
| Self Pay Ab774/Cbo Use Only | $567 - $4,246 | 126% |
| Us Dept Of Labor | $567 - $4,246 | 126% |
| Victim Of Violent Crime | $567 - $4,246 | 126% |
| Victoria Hospice | $567 - $4,246 | 126% |
| Brand New Day | $632 - $4,755 | 140% |
| Prime Health Srvs | $649 - $4,882 | 144% |
| Ihhi Reciprocity | $667 - $15,000 | 148% |
| Coventry Auto Network | $679 | 151% |
| Prime Health Srvs/Wc | $679 | 151% |
| Interplan | $687 - $2,280 | 152% |
| County Of Orange/Custody/Advanced Medmgt | $706 - $5,307 | 157% |
| Coventry Wc | $706 | 157% |
| Veterans Evaluation Services | $709 - $5,307 | 157% |
| Multiplan | $740 - $35,000 | 164% |
| Three Rivers | $740 | 164% |
| Velocity National Provider Network Wc | $755 | 168% |
| Workers Comp State Of California | $755 | 168% |
| Altamed Mcal Hmo (Ancillary) | $778 - $1,064 | 173% |
| Staywell/Island Home Ins | $794 - $5,944 | 176% |
| Three Rivers Network | $993 - $7,430 | 220% |
| Velocity National Provider Network Ppo | $993 - $7,430 | 220% |
| Cigna | $1,150 - $3,954 | 255% |
| First Health | $1,168 - $1,596 | 259% |
| Aetna | $1,217 - $1,677 | 270% |
| Heritage Provider Network | $1,334 - $5,815 | 296% |
| Magellan | $1,334 - $1,824 | 296% |
| Networks By Design | $1,557 - $2,128 | 345% |
| Networks By Design Wc | $1,557 - $2,128 | 345% |
| Healthsmart | $1,668 - $37,500 | 370% |
| Prime Health | $1,668 - $2,280 | 370% |
| Pnoa-Provider Network Of America | $1,779 - $2,432 | 395% |
| Prime Health Srvs/Network | $1,890 - $2,584 | 419% |
| Lucet Behavioral Health Sr | $2,224 - $3,040 | 493% |
| Managed Health Network | $2,224 - $3,040 | 493% |
| Other Insurance Loa | $2,224 - $3,040 | 493% |
| Other Non Contracted Plans | $2,224 - $3,040 | 493% |
| Private Pay | $2,224 - $3,040 | 493% |
| Us Behavioral Health Plan | $2,224 - $3,040 | 493% |
| Vitas Hospice | $2,224 - $3,040 | 493% |