CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Seneca District Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $57
  • Cash Discount Price: $82
  • vs. Medicare Baseline: 5.87x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Seneca District Hospital is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 5.87x the Medicare baseline. Located in 130 Brentwood Drive, Chester, CA.
Cash / Self-Pay
$82

Average discount available for prompt cash payment at this facility.

Insurance Median
$57

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: $82 (844%)
Insurance Median: $57 (587%)
Cash: $82 (844% of Medicare)
Ins. Median: $57 (587% 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 587% of the Medicare baseline (a markup of 487%). 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.

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
Amthem Bc Mcal $11 113%
Medi-Cal $11 113%
Partnership Hp-All Plans $11 113%
Ambetter / Centene $14 144%
UnitedHealthcare $22 - $144 227%
Tricare $40 - $103 412%
Imperial Hp Ma-All Plans $46 - $116 474%
Blue Cross Blue Shield $47 - $132 484%
Blue Shield Ipf/Ca Exchange $51 - $131 525%
Beech Street Corp- All Plans $55 - $139 566%
Cigna $55 - $139 566%
Integrated Hp-All Plans $55 - $139 566%
Interplan Corp- All Plans $55 - $139 566%
Medincrease- All Plans $55 - $139 566%
Multiplan- All Plans $55 - $139 566%
Pacificare - All Plans $55 - $139 566%
Provider Ntwrk Of America-All Plans $55 - $139 566%
Alliance- All Plans $56 - $142 577%
Community Care Network - All Plans $56 - $142 577%
Coventry- All Plans $56 - $144 577%
Northern Nevada Health Network- All Plans $56 - $144 577%
Superior California Ppo - All Plans $56 - $144 577%
Blue Shield Of Ca- All Other Plans $57 - $145 587%
Healthnet - All Other Plans $57 - $145 587%
Three Rivers- All Plans $57 - $145 587%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 130 Brentwood Drive, Chester, CA 96020
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals