CMS Price Transparency Data

Blood transfusion

Facility: The University of Vermont Health Network - Champl

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,099
Cash Discount Price: $1,885
vs. Medicare Baseline: 2.44x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at The University of Vermont Health Network - Champl is $1,099. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,885. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.44x the Medicare baseline. Located in 75 Beekman Street, Plattsburgh, NY.

Cash / Self-Pay

$1,885

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,099

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: $1,885 (418%)

Insurance Median: $1,099 (244%)

Cash: $1,885 (418% of Medicare)

Ins. Median: $1,099 (244% 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 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.

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
Capital District Physicians' Health Plan	$39 - $1,486	9%
Blue Cross Blue Shield	$275 - $4,128	61%
Humana	$507	112%
Aetna	$534 - $1,344	118%
Fidelis Care	$534	118%
Mvp	$534 - $1,500	118%
St. Regis	$534	118%
UnitedHealthcare	$534 - $1,438	118%
Veterans Affairs Community Care Network	$534	118%
Martins Point	$572	127%
Wellpath	$801	178%
Highmark Blueshield	$1,395	309%
Emblem Health	$1,508	335%
Harvard Pilgrim	$1,508	335%
Magnacare	$1,508	335%
Coventry	$1,696	376%
Multiplan	$1,791	397%

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 $1,885.
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 The University of Vermont Health Network - Champl 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.