CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Adventist Health St Helena

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $140
Cash Discount Price: $47
vs. Medicare Baseline: 14.42x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Adventist Health St Helena is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 14.42x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$47

Average discount available for prompt cash payment at this facility.

Insurance Median

$140

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$9.71

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $9.71 (100%)

Cash / Self-Pay: $47 (484%)

Insurance Median: $140 (1442%)

Cash: $47 (484% of Medicare)

Ins. Median: $140 (1442% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $9.71 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 1442% of the Medicare baseline (a markup of 1342%). 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
Blue Shield Behav Hlth	$4 - $144	41%
Blue Shield Epn-All Other Plans	$4 - $150	41%
Blue Shield Non-Epn	$4 - $148	41%
UnitedHealthcare	$4 - $203	41%
Phcs-All Plans	$5 - $175	51%
Western Growers-All Plans	$5 - $169	51%
Beech Street-All Plans	$6 - $239	62%
Choicecare-All Plans	$6 - $223	62%
Interplan-All Plans	$6 - $207	62%
Cigna	$7 - $255	72%
Health Management Network-All Plans	$7 - $271	72%
Kaiser-All Other Plans	$7 - $262	72%
Galaxy Network-All Plans	$8 - $287	82%
Three Rivers-All Plans	$8 - $287	82%
Va Medi-Cal	$9 - $11	93%
Blue Shield Bh Mcr Adv	$10	103%
Blue Shield Mcr Adv	$10	103%
Kaiser Mcr Adv	$10	103%
Tricare	$10	103%
Va Mcr - All Other Plans	$10	103%
Ah Employee Health Plan - All Plans	$17	175%
Healthnet-All Plans	$30 - $31	309%
Aetna	$57	587%
Blue Cross Blue Shield	$84 - $112	865%

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 $47.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 83036.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health St Helena is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 83036.
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.