Blood transfusion
Facility: Adventist Health Portland
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $1,102
- Cash Discount Price: $542
- vs. Medicare Baseline: 2.44x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 244% of the Medicare baseline (a markup of 144%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Healthcare Resources - All Plans | $331 - $430 | 73% |
| Ods - All Plans | $392 | 87% |
| Care Oregon - All Plans | $417 | 93% |
| Kaiser Mcr Adv | $490 | 109% |
| Humana | $500 - $520 | 111% |
| Workers Comp | $510 - $663 | 113% |
| Moda Mcr Adv | $520 | 115% |
| UnitedHealthcare | $520 - $1,149 | 115% |
| Healthnet Mcr Adv | $564 | 125% |
| Bc Premera First - All Plans | $736 - $958 | 163% |
| Healthnet Hmo/Pos - All Other Plans | $838 - $1,090 | 186% |
| Healthnet Epo/Pos/Ppo | $846 - $1,099 | 188% |
| Ah Employee Health Plan - All Plans | $883 | 196% |
| Worldventure - All Plans | $884 - $1,149 | 196% |
| Regence Ohsu Plus | $955 | 212% |
| Providence Hp - All Plans | $957 - $1,245 | 212% |
| Pacific Source Comm - All Plans | $972 - $1,264 | 216% |
| Moda Conn Oebb/Syn Pebb | $981 | 218% |
| First Choice - All Plans | $1,021 - $1,327 | 227% |
| Regence - All Other Plans | $1,061 | 235% |
| Multiplan - All Plans | $1,105 - $1,436 | 245% |
| Phcs - All Plans | $1,105 - $1,436 | 245% |
| Moda Affinity - All Other Plans | $1,128 | 250% |
| Aetna | $1,152 - $1,497 | 256% |
| First Health-Coventry - All Plans | $1,178 - $1,532 | 261% |
| Kaiser - All Other Plans | $1,279 | 284% |
| National Provider Network - All Plans | $1,296 - $1,685 | 288% |
| Health Payors Organization Ltd- All Plans | $1,326 - $1,724 | 294% |
| Moda Select | $1,535 | 341% |
| Moda Connexus | $1,736 | 385% |
| Moda Synergy | $1,836 | 407% |
| Moda Ohsu Ppo/Epo/Hmc | $2,651 - $3,447 | 588% |
| Cigna | $6,065 | 1346% |
| Regence Mcr Adv | $7,365 | 1634% |
| Regence Preferred Mcr Adv | $7,512 | 1667% |