CMS Price Transparency Data

Blood transfusion

Facility: Lewisgale Hospital Montgomery

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,888
Cash Discount Price: $4,045
vs. Medicare Baseline: 6.41x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Lewisgale Hospital Montgomery is $2,888. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,045. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 6.41x the Medicare baseline. Located in 3700 South Main Street, Blacksburg, VA.

Cash / Self-Pay

$4,045

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,888

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: $4,045 (897%)

Insurance Median: $2,888 (641%)

Cash: $4,045 (897% of Medicare)

Ins. Median: $2,888 (641% 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 641% of the Medicare baseline (a markup of 541%). 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	$704 - $1,683	156%
Universal Healthcare Group	$890 - $1,995	197%
Virginia Health Network	$1,416 - $2,872	314%
Aetna	$1,456 - $2,144	323%
United	$1,565 - $2,613	347%
Greenvbrier Sporting Club	$2,427	538%
Lifeworks	$2,550	566%
Blue Cross Blue Shield	$2,614 - $2,905	580%
Corvel	$2,912	646%
Richfield Nursing Center	$3,034	673%
Richfield Retirement Community	$3,034	673%
Multiplan	$3,115	691%
Community Care Network	$3,236	718%
Graham-White Manufacturing	$3,236	718%
Occunet Workers Comp	$3,236	718%
One Health Plan	$3,236	718%
Phcs	$3,438	763%
Patients Choice	$3,560	790%
4Most	$3,640	808%
American Postal Workers Union	$3,640	808%
Star Transportation	$3,640	808%

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 $4,045.
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 Hospital Montgomery 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.