CMS Price Transparency Data

Blood transfusion

Facility: Loma Linda University Children's Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $955
Cash Discount Price: $1,128
vs. Medicare Baseline: 2.12x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Loma Linda University Children's Hospital is $955. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,128. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.12x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$1,128

Average discount available for prompt cash payment at this facility.

Insurance Median

$955

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: $1,128 (250%)

Insurance Median: $955 (212%)

Cash: $1,128 (250% of Medicare)

Ins. Median: $955 (212% 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 212% of the Medicare baseline (a markup of 112%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Adventist Health	$501	111%
Alpha Care Medical Group	$555 - $833	123%
Dignity Health	$555 - $833	123%
Epic Health Plan	$555 - $1,002	123%
Inland Empire Health Plan (Iehp)	$555 - $973	123%
Kaiser Foundation Hospitals	$555 - $1,672	123%
Upland Medical Group	$555	123%
Vantage Medical Group	$555 - $833	123%
Lluh Dept Of Risk Management	$601	133%
UnitedHealthcare	$605 - $1,253	134%
Molina Healthcare Of Ca	$700 - $744	155%
Prime Health Services	$876 - $2,130	194%
Multiplan	$885 - $2,005	196%
Heritage Provider Network	$911	202%
Global Benefits Group	$1,504	334%
Temecula Valley Physicians Medical Group	$1,504	334%
Trivalley Medical Group	$1,504	334%
Cigna	$1,604 - $1,854	356%
Networks By Design	$1,629	361%
Galaxy Health	$2,130	473%
Aetna	$3,429	761%
Blue Cross Blue Shield	$5,398	1198%

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 $1,128.
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 Loma Linda University Children's 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.