CMS Price Transparency Data

Blood transfusion

Facility: Pali Momi Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $942
Cash Discount Price: $859
vs. Medicare Baseline: 2.09x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Pali Momi Medical Center is $942. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $859. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.09x the Medicare baseline. Located in 98-1079 Moanalua Road, Aiea, HI.

Cash / Self-Pay

$859

Average discount available for prompt cash payment at this facility.

Insurance Median

$942

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: $859 (191%)

Insurance Median: $942 (209%)

Cash: $859 (191% of Medicare)

Ins. Median: $942 (209% 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 209% of the Medicare baseline (a markup of 109%). 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
Alohacare	$49 - $570	11%
Ohana	$51 - $622	11%
UnitedHealthcare	$495	110%
Hmsa	$518 - $2,798	115%
Mdx	$518 - $1,084	115%
Devoted	$544	121%
Uha	$584 - $904	130%
Hwmg/Hmaa	$700 - $1,084	155%
Verdegard	$700 - $1,084	155%
Calvos	$817 - $1,265	181%
Mimoh	$817 - $1,265	181%
Pac Admin	$817 - $1,265	181%
Kaiser	$934 - $1,446	207%
Multiplan	$934 - $1,536	207%
Coventry	$992 - $1,536	220%
Mccp	$992 - $1,536	220%
Hcha	$2,625	582%

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 $859.
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 Pali Momi 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.