CMS Price Transparency Data

Blood transfusion

Facility: Mayers Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $374
Cash Discount Price: $1,006
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Mayers Memorial Hospital is $374. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,006. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.83x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.

Cash / Self-Pay

$1,006

Average discount available for prompt cash payment at this facility.

Insurance Median

$374

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: $1,006 (223%)

Insurance Median: $374 (83%)

Cash: $1,006 (223% of Medicare)

Ins. Median: $374 (83% 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
Medi-Cal	$25 - $394	6%
Blue Shield Ca Va	$49 - $247	11%
Blue Shield Mcr Adv	$49 - $247	11%
Tricare	$49 - $260	11%
Health Net Mcr Adv	$51 - $260	11%
Arcadian Health Services-All Plans	$54 - $260	12%
Imperial Health Plan-All Plans	$58 - $294	13%
Blue Cross Blue Shield	$263 - $337	58%
Health Net Prison	$283	63%
Blue Shield Ca Exchange	$337	75%
Blue Shield-All Other Plans	$374	83%
Cigna	$374 - $1,537	83%
Corvel Ppo-All Plans	$374 - $1,537	83%
Coventry/First Health-All Plans	$374 - $1,537	83%
Hmn-All Plans	$374	83%
Integrated Hp-All Plans	$374 - $1,537	83%
Interplan-All Plans	$374 - $1,537	83%
Multiplan Phcs-All Plans	$374	83%
Pfmc-All Plans	$374	83%
Superior Ca-All Plans	$374	83%
Health Net-All Other Plans	$392	87%
Pacificare-All Plans	$394	87%
Partnership Hp-All Plans	$1,576	350%

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 $1,006.
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 Mayers Memorial 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.