CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Sonoma Valley Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $60
  • Cash Discount Price: $189
  • vs. Medicare Baseline: 6.18x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Sonoma Valley Hospital is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $189. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 6.18x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$189

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $189 (1946%)
Insurance Median: $60 (618%)
Cash: $189 (1946% of Medicare)
Ins. Median: $60 (618% 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 618% of the Medicare baseline (a markup of 518%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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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 Cross Blue Shield $10 - $270 103%
Bright Hlth/Brand New Day Mcr Adv $10 103%
Hospice Of Marin-All Plans $10 103%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $10 103%
St Joseph Heritage Hltcare Comm-All Other Plans $10 103%
Tricare $10 103%
Veterans Admin-All Plans $10 103%
Medi-Cal $11 113%
Partnership Healthplan-All Plans $11 113%
Cdcr Prison-All Plans $12 124%
Three Rivers (Trpn)-All Plans $12 124%
Bright Hlth/Brand New Day - All Other Plands $13 134%
Chp - Correctional Health Partners - All Plans $13 134%
Wellpath - All Plans $14 144%
Aetna $16 165%
First Health(Coventry)-All Plans $16 165%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $17 175%
Canopy Health Solutions-All Other Plans $17 175%
Mcal Mgd Care (Php)-All Plans $18 185%
UnitedHealthcare $20 206%
Meritage Medical Network Op Only Mcare $26 268%
Meritage Medical Network Op Only-All Other Plans $26 268%
Healthnet Hmo/Ppo-All Other Plans $94 968%
Blue Shield Ppo-All Plans $153 1576%
Kaiser-All Plans $176 1813%
Integrated Health Plan-All Plans $200 2060%
Champus-All Plans $216 2225%
Cigna $216 2225%
Networks By Design - All Plans $216 2225%
Comm Care Network(Ccn)-All Plans $230 2369%
Great West-One Health Plan Ppo/Pos-All Plans $230 2369%
Phcs/Multiplan/Beech St-All Plans $230 2369%
Interplan-All Plans $238 2451%
Bps-All Plans $243 2503%
Ppo Alliance-All Plans $243 2503%
Pref Health Networl(Phn)-All Plans $243 2503%
Scan Mcare-All Plans $270 2781%
St Joseph Heritage Hltcare Mcr Adv $270 2781%
Correct Care Integ Health-All Plans $324 3337%
Employer Direct Healthcare-All Plans $324 3337%
Creative Legal Services-All Plans $351 3615%
Canopy Op Only $486 5005%
Vnpn - All Plans $486 5005%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals