CMS Price Transparency Data

Blood transfusion

Facility: Brattleboro Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $588
Cash Discount Price: $485
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Brattleboro Memorial Hospital is $588. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $485. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.30x the Medicare baseline. Located in 17 Belmont Ave, Brattleboro, VT.

Cash / Self-Pay

$485

Average discount available for prompt cash payment at this facility.

Insurance Median

$588

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: $485 (108%)

Insurance Median: $588 (130%)

Cash: $485 (108% of Medicare)

Ins. Median: $588 (130% 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
Amerihealth-Caritas	$37 - $338	8%
New Hampshire Healthy Families	$37 - $338	8%
Wellsense	$37 - $449	8%
Blue Cross Blue Shield	$41 - $640	9%
Cigna	$41 - $675	9%
Harvard Pilgrim Health Care	$41 - $618	9%
Martin'S Point	$41 - $419	9%
Mvp Healthcare	$41 - $640	9%
New Hampshire Healthy Families (Wellcare)	$43 - $440	10%
Vermont Health Plan	$46 - $636	10%
Tufts Health Plan	$86 - $650	19%
Humana	$419	93%
UnitedHealthcare	$419 - $675	93%
Multiplan	$587 - $689	130%
Aetna	$656 - $689	146%
Coventry	$656 - $689	146%
Health New England	$656 - $689	146%

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 $485.
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 Brattleboro Memorial 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.