CMS Price Transparency Data

Blood transfusion

Facility: John Randolph Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,380
Cash Discount Price: $6,355
vs. Medicare Baseline: 5.28x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at John Randolph Medical Center is $2,380. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,355. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 5.28x the Medicare baseline. Located in 411 West Randolph Road, Hopewell, VA.

Cash / Self-Pay

$6,355

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,380

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: $6,355 (1410%)

Insurance Median: $2,380 (528%)

Cash: $6,355 (1410% of Medicare)

Ins. Median: $2,380 (528% 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 528% of the Medicare baseline (a markup of 428%). 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
Cigna	$909 - $3,591	202%
Oscar	$1,080 - $2,651	240%
United	$1,203 - $2,860	267%
Universal Healthcare Group	$1,398 - $1,995	310%
Aetna	$2,034 - $2,097	451%
Blue Cross Blue Shield	$2,147 - $2,954	476%
Virginia Health Network	$2,224 - $4,131	493%
Lifeworks	$2,550	566%
Value Options	$3,813	846%
Corvel	$4,576	1015%
Occunet Workers Comp	$5,084	1128%
4Most Health Nework	$5,720	1269%
Multiplan	$5,720	1269%

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 $6,355.
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 John Randolph Medical Center 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.