CMS Price Transparency Data

Blood transfusion

Facility: Carilion Tazewell Community Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $900
Cash Discount Price: $573
vs. Medicare Baseline: 2.00x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Carilion Tazewell Community Hospital is $900. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $573. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.00x the Medicare baseline. Located in 388 Ben Bolt Avenue, Tazewell, VA.

Cash / Self-Pay

$573

Average discount available for prompt cash payment at this facility.

Insurance Median

$900

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: $573 (127%)

Insurance Median: $900 (200%)

Cash: $573 (127% of Medicare)

Ins. Median: $900 (200% 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
Corvel	$34	8%
Blue Cross Blue Shield	$38 - $2,329	8%
Sentara Health Plan	$39 - $1,014	9%
Abh Of Va (Formerly Coventry)	$40	9%
Abh Of Wva (Formerly Coventry)	$40	9%
Humana	$40 - $420	9%
UnitedHealthcare	$40 - $1,337	9%
Aetna	$387 - $1,086	86%
Allcare	$412	91%
Gateway - Tier 3	$900	200%
Vhn - Ultra	$1,014	225%
Cigna	$1,039 - $1,108	231%
Connecticare	$1,145	254%
Vhn - Plus	$1,260	280%
Gateway - Tier 2	$1,309	290%
Vhn	$1,309	290%
Integrated Health Plan	$1,391	309%
Vhn - Link	$1,472	327%
Gateway - Tier 1	$1,554	345%
Vhn - Secondary Payors	$1,554	345%
National Provider Network	$1,571	349%

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 $573.
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 Carilion Tazewell Community Hospital 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.