CMS Price Transparency Data

Blood transfusion

Facility: Banner Lassen Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,156
Cash Discount Price: $676
vs. Medicare Baseline: 2.56x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Banner Lassen Medical Center is $1,156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $676. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.56x the Medicare baseline. Located in 1800 Spring Ridge Drive, Susanville, CA.

Cash / Self-Pay

$676

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,156

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: $676 (150%)

Insurance Median: $1,156 (256%)

Cash: $676 (150% of Medicare)

Ins. Median: $1,156 (256% 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 256% of the Medicare baseline (a markup of 156%). 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
Blue Cross Blue Shield	$87	19%
Banner Health	$436 - $654	97%
UnitedHealthcare	$436 - $1,483	97%
Network Providers, Llc	$567 - $850	126%
Imperial Health Plan Of California, Inc	$588 - $883	130%
Blue Shield Of California	$925 - $1,388	205%
Multiplan	$957 - $1,436	212%
Cigna	$1,010 - $1,515	224%
Coventry	$1,020 - $1,531	226%
First Health	$1,020 - $1,531	226%
Health Net	$1,031 - $1,547	229%

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 $676.
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 Banner Lassen Medical Center 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.