CMS Price Transparency Data

Blood transfusion

Facility: Reston Hospital Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,103
Cash Discount Price: $3,685
vs. Medicare Baseline: 4.67x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Reston Hospital Center is $2,103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,685. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 4.67x the Medicare baseline. Located in 1850 Town Center Parkway, Reston, VA.

Cash / Self-Pay

$3,685

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,103

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: $3,685 (818%)

Insurance Median: $2,103 (467%)

Cash: $3,685 (818% of Medicare)

Ins. Median: $2,103 (467% 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 467% of the Medicare baseline (a markup of 367%). 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	$730 - $2,338	162%
Universal Healthcare Group	$811 - $1,995	180%
Bright Health	$926 - $2,644	205%
Carefirst	$968 - $1,621	215%
United	$1,032 - $1,770	229%
Aetna	$1,216	270%
Greenvbrier Sporting Club	$2,211	491%
Blue Cross Blue Shield	$2,390 - $2,589	530%
Lifeworks	$2,550	566%
Virginia Health Network	$2,616	580%
Corvel	$2,653	589%
Occunet Workers Comp	$2,948	654%
4Most Health Network	$3,316	736%

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 $3,685.
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 Reston Hospital 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.