CMS Price Transparency Data

Blood transfusion

Facility: Uva Health Haymarket Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,077
Cash Discount Price: $874
vs. Medicare Baseline: 2.39x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Uva Health Haymarket Medical Center is $1,077. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $874. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.39x the Medicare baseline. Located in 15225 Healthcote Boulevard, Haymarket, VA.

Cash / Self-Pay

$874

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,077

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: $874 (194%)

Insurance Median: $1,077 (239%)

Cash: $874 (194% of Medicare)

Ins. Median: $1,077 (239% 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 239% of the Medicare baseline (a markup of 139%). 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
Champva [50002]	$39 - $40	9%
Tricare	$39 - $40	9%
Sentara [40021]	$162 - $1,357	36%
Sentara Behavioral Health [40052]	$165 - $1,357	37%
Blue Ridge Pace [10510]	$398	88%
Medicaid / KanCare	$398	88%
Aetna	$443 - $2,075	98%
Blue Cross Blue Shield	$443 - $1,411	98%
Cigna	$443 - $1,398	98%
HMO Part B [10099]	$443	98%
Humana	$443 - $466	98%
Medicare (plans)	$443 - $456	98%
UnitedHealthcare	$443 - $1,695	98%
VA Ccn [99926]	$443 - $456	98%
VA Ccn [99927]	$443 - $456	98%
Veterans Administration [99910]	$456	101%
Carefirst [30007]	$926	205%
Geha [40009]	$1,083 - $1,370	240%
Beacon Health Options [40012]	$1,179	262%
Commercial Contracted Hb Only [40056]	$1,238	275%
Commercial Generic [40000]	$1,238 - $1,651	275%
Multiplan Generic [40035]	$1,328 - $2,004	295%
Vhn Generic [40040]	$1,328 - $2,004	295%
Commercial Contracted Tpa [40055]	$1,415 - $1,651	314%
Kaiser Permenente [40014]	$1,572	349%
Umwa [40037]	$1,651	366%
Healthsmart [40013]	$1,768	392%
First Health Generic [40033]	$1,934	429%
Gateway Health Alliance [40034]	$2,004	445%
Onenet Workers Comp Generic [60010]	$2,066	458%

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 $874.
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 Uva Health Haymarket 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.