CMS Price Transparency Data

Blood transfusion

Facility: Memorial Care Miller Children's & Women's Hosp Lb

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,445
Cash Discount Price: $5,192
vs. Medicare Baseline: 3.21x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Memorial Care Miller Children's & Women's Hosp Lb is $1,445. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,192. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.21x the Medicare baseline. Located in 2801 Atlantic Avenue, Long Beach, CA.

Cash / Self-Pay

$5,192

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,445

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: $5,192 (1152%)

Insurance Median: $1,445 (321%)

Cash: $5,192 (1152% of Medicare)

Ins. Median: $1,445 (321% 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 321% of the Medicare baseline (a markup of 221%). 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
Select Health	$369	82%
Monarch Health Plan	$539 - $1,504	120%
Caremore	$567	126%
Blue Cross Blue Shield	$594 - $1,611	132%
Global Care Medical Group	$681	151%
Healthcare Partners	$709 - $1,543	157%
UnitedHealthcare	$786 - $1,887	174%
Molina	$919	204%
Aetna	$1,275 - $2,195	283%
Centivo	$1,277	283%
Blue Shield	$1,304 - $2,088	289%
Cigna	$1,610 - $2,562	357%
Healthnet	$2,044 - $2,920	453%

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 $5,192.
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 Memorial Care Miller Children's & Women's Hosp Lb 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.