CMS Price Transparency Data

Blood transfusion

Facility: OHSU Hospital and Clinics

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,013
Cash Discount Price: $1,081
vs. Medicare Baseline: 2.25x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at OHSU Hospital and Clinics is $1,013. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,081. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.25x the Medicare baseline. Located in 3181 Sw Sam Jackson Park Road, Portland, OR.

Cash / Self-Pay

$1,081

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,013

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: $1,081 (240%)

Insurance Median: $1,013 (225%)

Cash: $1,081 (240% of Medicare)

Ins. Median: $1,013 (225% 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 225% of the Medicare baseline (a markup of 125%). 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
Community Health Plan Of Washington	$268 - $694	59%
Care Oregon	$396 - $585	88%
Intercommunity Health Network	$396	88%
Kaiser Foundation Hospitals	$396 - $1,152	88%
Medicare (plans)	$396 - $793	88%
Pacific Source	$396 - $1,424	88%
Humana	$495 - $525	110%
Trillium	$495	110%
Moda	$520 - $1,724	115%
UnitedHealthcare	$525 - $1,830	116%
Aetna	$535 - $1,427	119%
Health Net Health Plan Of Oregon, Inc.	$570 - $1,417	126%
Providence Health Plan	$594 - $1,556	132%
Samaritan Health Plan	$767 - $1,239	170%
Tuality Health	$892	198%
Coventry First Health	$1,046 - $1,372	232%
First Choice	$1,056 - $1,387	234%
Cigna	$1,274 - $1,673	283%
Blue Cross Blue Shield	$1,393	309%
Molina Exchange	$1,394 - $1,830	309%

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 $1,081.
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 OHSU Hospital and Clinics 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.