CMS Price Transparency Data

Blood transfusion

Facility: Sherman Oaks Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $573
Cash Discount Price: $564
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Sherman Oaks Hospital is $573. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $564. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.27x the Medicare baseline. Located in 4929 Van Nuys Blvd, Sherman Oaks, CA.

Cash / Self-Pay

$564

Average discount available for prompt cash payment at this facility.

Insurance Median

$573

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: $564 (125%)

Insurance Median: $573 (127%)

Cash: $564 (125% of Medicare)

Ins. Median: $573 (127% 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.

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
Aids Healthcare Foundation	$565 - $576	125%
Alignment	$565	125%
Blue Shield Of Ca, Va	$565	125%
Elite Health Plan	$565	125%
Health Net Of Ca	$565 - $824	125%
Imperial Health Plan	$565	125%
L.A Care Health Plan	$565	125%
Managed Health Network	$565	125%
Medicare (plans)	$565	125%
Molina	$565	125%
Renal Payer Solutions	$565	125%
Tricare	$565	125%
Usa Senior Care Network	$565	125%
Brand New Day	$570 - $847	126%
Corvel	$644	143%
Zelis Healthcare	$644	143%
Americas Choice Provider Network	$657	146%
Multiplan	$657	146%
Prime Health Services	$657	146%
Three Rivers	$657	146%
Healthsmart Preferred Network	$664	147%
Provider Select	$671	149%
Provider Network Of America	$678	150%
Aetna	$722	160%
Ca Foundation For Medical Center	$744	165%
Worker Comp	$744	165%
Employer Direct Healthcare	$790	175%
Naphcare	$875	194%

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 $564.
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 Sherman Oaks Hospital 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.