CMS Price Transparency Data

Blood transfusion

Facility: Stafford Hospital, LLC

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $612
Cash Discount Price: $784
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Stafford Hospital, LLC is $612. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $784. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.36x the Medicare baseline. Located in 101 Hospital Center Boulevard, Stafford, VA.

Cash / Self-Pay

$784

Average discount available for prompt cash payment at this facility.

Insurance Median

$612

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: $784 (174%)

Insurance Median: $612 (136%)

Cash: $784 (174% of Medicare)

Ins. Median: $612 (136% 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
Sentara	$260 - $600	58%
Medcost	$344	76%
Aetna	$352 - $4,450	78%
PHCS	$352	78%
Humana	$414 - $600	92%
Molina	$431 - $624	96%
Kaiser	$443 - $642	98%
Blue Cross Blue Shield	$600 - $936	133%
UnitedHealthcare	$600 - $991	133%
Cf	$712 - $822	158%
Cigna	$2,124 - $2,655	471%
Innovation	$2,582 - $2,840	573%

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 $784.
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 Stafford Hospital, LLC 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.