CMS Price Transparency Data

Blood transfusion

Facility: Astria Sunnyside Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $814
Cash Discount Price: $902
vs. Medicare Baseline: 1.81x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Astria Sunnyside Hospital is $814. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $902. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.81x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$902

Average discount available for prompt cash payment at this facility.

Insurance Median

$814

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: $902 (200%)

Insurance Median: $814 (181%)

Cash: $902 (200% of Medicare)

Ins. Median: $814 (181% 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
Medicare (plans)	$50 - $400	11%
Aetna	$388 - $1,393	86%
Healthcomp_Ihs	$388	86%
Humana	$388 - $1,425	86%
Medicaid / KanCare	$388 - $485	86%
Molina	$388	86%
Va	$388	86%
Tricare	$392	87%
Regence	$814	181%
Cigna	$950	211%
Li	$972	216%
First_Choice	$1,187	263%
Tpsc	$1,235	274%
Kaiser	$1,243	276%
Premera	$1,289	286%
UnitedHealthcare	$1,346	299%
Fhpw	$1,393	309%
Healthcomp	$1,425	316%
Bcchp	$1,583	351%
Great_Rivers	$1,583	351%
Zenith	$1,583	351%

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 $902.
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 Astria Sunnyside Hospital 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.