CMS Price Transparency Data

Blood transfusion

Facility: Shriners Hospitals for Children Northern Calif

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $497
Cash Discount Price: $2,192
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Shriners Hospitals for Children Northern Calif is $497. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,192. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.10x the Medicare baseline. Located in 2425 Stockton Boulevard, Sacramento, CA.

Cash / Self-Pay

$2,192

Average discount available for prompt cash payment at this facility.

Insurance Median

$497

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: $2,192 (486%)

Insurance Median: $497 (110%)

Cash: $2,192 (486% of Medicare)

Ins. Median: $497 (110% 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
Caresource Of Ga	$26	6%
Wellcare Of Ga	$26	6%
Gateway Health Plan	$28	6%
Amerigroup Nv	$29	6%
Ambetter / Centene	$32 - $658	7%
Health Plan Of Nv	$32	7%
Soonercare	$35	8%
Aetna	$257 - $988	57%
Medicaid / KanCare	$257	57%
Molina Healthcare Of Ms	$432	96%
Amerihealth Caritas Nc	$497	110%
Amerihealth Caritas Sc	$497	110%
Caresource Of Oh	$497	110%
Northbay Healthcare	$573	127%
Sana Benefits	$605 - $802	134%
Sutter Medical Foundation	$630	140%
Health Net Of Ca	$658	146%
Healthchoice Of Oklahoma	$743	165%
UnitedHealthcare	$840	186%
Blue Cross Blue Shield	$946	210%

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 $2,192.
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 Shriners Hospitals for Children Northern Calif 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.