CMS Price Transparency Data

Blood transfusion

Facility: Lewisgale Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,741
Cash Discount Price: $3,916
vs. Medicare Baseline: 6.08x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Lewisgale Medical Center is $2,741. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,916. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 6.08x the Medicare baseline. Located in 1900 Electric Road, Salem, VA.

Cash / Self-Pay

$3,916

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,741

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: $3,916 (869%)

Insurance Median: $2,741 (608%)

Cash: $3,916 (869% of Medicare)

Ins. Median: $2,741 (608% 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 608% of the Medicare baseline (a markup of 508%). 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	$681 - $1,723	151%
Universal Healthcare Group	$862 - $1,995	191%
Virginia Health Network	$1,371 - $2,780	304%
Aetna	$1,410 - $2,075	313%
Greenbrier Sporting Club	$1,423	316%
United	$1,429 - $2,562	317%
Naphcare	$1,958	434%
Blue Cross Blue Shield	$2,122 - $2,358	471%
Greenvbrier Sporting Club	$2,350	521%
Lifeworks	$2,550	566%
Graham-White Manufacturing	$2,741	608%
Richfield Nursing Center	$2,741	608%
Corvel	$2,820	626%
Community Care Network	$2,937	652%
Richfield Retirement Community	$2,937	652%
Csx Hotels	$3,133	695%
Occunet Workers Comp	$3,133	695%
One Health Plan	$3,133	695%
Patients Choice	$3,446	765%
4Most	$3,524	782%
Alleghany Highland Community	$3,524	782%
American Postal Workers Union	$3,524	782%
C&O Employees Hospital Assn	$3,524	782%
Multiplan	$3,524	782%
Phcs	$3,524	782%
Star Transportation	$3,524	782%

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 $3,916.
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 Lewisgale 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.