CMS Price Transparency Data

Blood transfusion

Facility: Stonesprings Hospital Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,219
Cash Discount Price: $3,501
vs. Medicare Baseline: 4.92x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Stonesprings Hospital Center is $2,219. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,501. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 4.92x the Medicare baseline. Located in 24440 Stone Springs Boulevard, Dulles, VA.

Cash / Self-Pay

$3,501

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,219

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: $3,501 (777%)

Insurance Median: $2,219 (492%)

Cash: $3,501 (777% of Medicare)

Ins. Median: $2,219 (492% 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 492% of the Medicare baseline (a markup of 392%). 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	$693 - $2,338	154%
Bright Health	$880 - $2,644	195%
Carefirst	$968 - $1,541	215%
United	$1,092 - $1,770	242%
Aetna	$1,155	256%
Greenvbrier Sporting Club	$2,101	466%
Blue Cross Blue Shield	$2,395 - $2,595	531%
Virginia Health Network	$2,486	552%
Corvel	$2,521	559%
Lifeworks	$2,550	566%
Three Rivers Provider Network	$2,976	660%

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 $3,501.
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 Stonesprings 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.