CMS Price Transparency Data

Blood transfusion

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $60
Cash Discount Price: $952
vs. Medicare Baseline: 0.13x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at The University of Vermont Health Network-Alice Hy is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $952. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.13x the Medicare baseline. Located in 133 Park Street, Po Box 729, Malone, NY.

Cash / Self-Pay

$952

Average discount available for prompt cash payment at this facility.

Insurance Median

$60

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: $952 (211%)

Insurance Median: $60 (13%)

Cash: $952 (211% of Medicare)

Ins. Median: $60 (13% 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
Capital District Physicians' Health Plan	$27 - $1,216	6%
UnitedHealthcare	$28 - $1,276	6%
Blue Cross Blue Shield	$29 - $1,415	6%
Fidelis Care	$33 - $414	7%
Humana	$33 - $414	7%
Mvp	$33 - $414	7%
Choicecare	$38 - $971	8%
Aetna	$39 - $1,114	9%
Martins Point	$39 - $414	9%
Veterans Affairs Community Care Network	$39 - $414	9%
St. Regis	$414 - $487	92%
Magnacare	$487 - $1,036	108%
Highmark Blueshield	$597 - $1,160	132%

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 $952.
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-Alice Hy 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.