CMS Price Transparency Data
Blood transfusion
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $315
- Cash Discount Price: $683
- vs. Medicare Baseline: 0.70x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Saint Alphonsus Medical Center Ontario is $315. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $683. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.70x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$683
Average discount available for prompt cash payment at this facility.
Insurance Median
$315
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: $683 (152%)
Insurance Median: $315 (70%)
Cash: $683 (152% of Medicare)
Ins. Median: $315 (70% 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.
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 |
|---|---|---|
| Medicaid / KanCare | $179 - $315 | 40% |
| Ada County Jail Inmate Ins | $315 | 70% |
| Aetna | $315 - $995 | 70% |
| Ambetter / Centene | $315 | 70% |
| Amish Mennonite | $315 | 70% |
| Bcccp-Michigan | $315 | 70% |
| Bccp | $315 | 70% |
| Blue Cross Blue Shield | $315 - $1,625 | 70% |
| Bmc Healthnet | $315 | 70% |
| Breast Grant-Connecticut | $315 | 70% |
| California Health And Wellness | $315 | 70% |
| Cardinal Innovations Lme | $315 | 70% |
| Care Oregon Ohp | $315 | 70% |
| Cencal Health Plan | $315 | 70% |
| Cenpatico | $315 | 70% |
| Centurion Of Idaho | $315 | 70% |
| Chhuny | $315 | 70% |
| Childrens Comm Health Plan | $315 | 70% |
| Childrens Medical Services Title 19 | $315 | 70% |
| Cigna | $315 - $988 | 70% |
| Community Benefit Health | $315 | 70% |
| Community Care Behavorial Health | $315 | 70% |
| Community Health Choice | $315 | 70% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $315 | 70% |
| Dean Wi Badgercare | $315 | 70% |
| Delaware First Health | $315 | 70% |
| Delta Dental Nj | $315 | 70% |
| Dph Tb Program | $315 | 70% |
| Dscc | $315 | 70% |
| Eastpointe Lme | $315 | 70% |
| Family Health Network | $315 | 70% |
| Freedom First Healthcare | $315 | 70% |
| Ghc Scw Wi Badgercare | $315 | 70% |
| Harbor Health | $315 | 70% |
| Health Safety Net | $315 | 70% |
| Healthy Blue Ne | $315 | 70% |
| Hennepin Health | $315 | 70% |
| Humana | $315 - $925 | 70% |
| Id County Ada | $315 | 70% |
| Id County Canyon | $315 | 70% |
| Id County Cat Fund | $315 | 70% |
| Id County Payette | $315 | 70% |
| Idaho Womens Health Check | $315 | 70% |
| Indiana Breast Cervical Cancer | $315 | 70% |
| Inland Empire Health Plan | $315 | 70% |
| Intercommunity Health Ohp | $315 | 70% |
| Iowa Total Care | $315 | 70% |
| Jai Medical System | $315 | 70% |
| Kern Family Health Plan | $315 | 70% |
| Keystone First | $315 | 70% |
| Keystone First Chip | $315 | 70% |
| La Care Health Plan | $315 | 70% |
| Lakeland Care Inc | $315 | 70% |
| Managed Health Services - Indiana | $315 | 70% |
| Maryland Breast & Cervical Program | $315 | 70% |
| Maryland Healthy Smiles - Scion Dental | $315 | 70% |
| Maryland Physicians Care | $315 | 70% |
| Massachusetts Behavioral Health Partnership | $315 | 70% |
| Mdwise | $315 | 70% |
| Medi-Cal | $315 | 70% |
| Medi-Cal Healthnet | $315 | 70% |
| Medstar Dc Healthy Family | $315 | 70% |
| Medstar Md Health Choice | $315 | 70% |
| Mo Home State Health Plan | $315 | 70% |
| Molina Centennial Care | $315 | 70% |
| Nascentia Health Options | $315 | 70% |
| Nebraska Total Care | $315 | 70% |
| New York Cancer Services Program | $315 | 70% |
| Nextlevel Health | $315 | 70% |
| Oregon Screenwise | $315 | 70% |
| Pace Of Southwest Michigan | $315 | 70% |
| Paramount Advantage | $315 | 70% |
| Parkland Community Health Plan | $315 | 70% |
| Partners Behavioral Lme | $315 | 70% |
| Peach State Healthplan | $315 | 70% |
| Presbyterian Centennial Care | $315 | 70% |
| Prestige Health Choice | $315 | 70% |
| Priority Partners | $315 | 70% |
| Rx 340B Pass Along | $315 | 70% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $315 | 70% |
| Rx Medi-Cal | $315 | 70% |
| Rx Meridian Rx | $315 | 70% |
| Sandhills Center Lme | $315 | 70% |
| Screening For Life | $315 | 70% |
| Sunshine State Health Plan | $315 | 70% |
| Superior Health | $315 | 70% |
| Tenncare | $315 | 70% |
| Texas Children'S Health Plan | $315 | 70% |
| Trillium Community Ohp | $315 | 70% |
| Tufts Health Public Plans | $315 | 70% |
| UnitedHealthcare | $315 - $1,009 | 70% |
| Vaya Health Lme | $315 | 70% |
| Wellsense Health Plan | $315 | 70% |
| Wi Womens Wellness | $315 | 70% |
| Medicare (plans) | $515 - $551 | 114% |
| American Health Advantage Of Idaho | $535 | 119% |
| Mountain Health Co-Op | $631 | 140% |
| Pacificsource Health Plans | $631 - $988 | 140% |
| Selecthealth | $695 - $946 | 154% |
| Allegiance | $799 | 177% |
| Correctional Health Partners | $820 | 182% |
| Columbia Health Network | $841 | 187% |
| Healthnet | $883 | 196% |
| Allied National Global Care | $946 | 210% |
| Asrm - Reliance Standard Life Insurance | $946 | 210% |
| Christian Care Ministry | $946 | 210% |
| Dean Health | $946 | 210% |
| Fallon Health | $946 | 210% |
| Family Life Insurance Company | $946 | 210% |
| First Choice Health | $946 | 210% |
| Ghc Scw | $946 | 210% |
| International Benefit Administrators | $946 | 210% |
| Lifetime Benefit Solutions | $946 | 210% |
| Manhattan Life | $946 | 210% |
| Pai | $946 | 210% |
| Pan-American Life | $946 | 210% |
| Paramount Hmo | $946 | 210% |
| Phcs | $946 | 210% |
| Trinity Health Share | $946 | 210% |
| Webtpa | $946 - $1,387 | 210% |
| Lifewise | $977 | 217% |
| Priority Health | $988 | 219% |
| Allied Benefit Systems | $995 | 221% |
| Ameriben | $995 | 221% |
| Asr Health Benefits | $995 | 221% |
| Christian Brother Services | $995 | 221% |
| Geha | $995 - $1,009 | 221% |
| Healthez | $995 | 221% |
| Luminare Health (Detroit) | $995 | 221% |
| Rural Carrier Health Benefit Plan | $995 | 221% |
| First Health | $998 | 221% |
| Medi Share | $998 | 221% |
| Providence | $998 | 221% |
| Moda Health | $1,019 - $1,020 | 226% |
| Blue Benefit Administrators Of Massachusetts | $1,625 | 361% |
| Blue Care Network | $1,625 | 361% |
| Blue Distinction Transplant | $1,625 | 361% |
| Blue Shield - Ca | $1,625 | 361% |
| Blue Shield - Id (Regence) | $1,625 | 361% |
| Blue Shield - Ny Highmark Northeastern | $1,625 | 361% |
| Blue Shield - Ny Highmark Western | $1,625 | 361% |
| Blue Shield - Pa (Highmark) | $1,625 | 361% |
| Blue Shield - Wa (Regence) | $1,625 | 361% |
| Healthcare Management Admin | $1,653 | 367% |