CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Valley Children's Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $48
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.94x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Valley Children's Hospital is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 4.94x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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%)
Insurance Median: $48 (494%)
Ins. Median: $48 (494% 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 494% of the Medicare baseline (a markup of 394%). 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
Allcare Ipa $14 - $200 144%
Central California Alliance For Health $19 196%
Dignity Ipa_Formerly Img $19 196%
La Salle Ipa $19 196%
Sante Ipa $19 196%
Kaiser $20 - $259 206%
Central Valley Medical Providers Ipa $21 - $200 216%
Sequoia Health Ipa $21 216%
United Physicians Network Ipa $21 - $200 216%
Univseral Healthcare Ipa $21 216%
Community Care Ipa $22 227%
Health Net $22 - $261 227%
Adventist $24 247%
Blue Cross Blue Shield $25 - $96 257%
Cencal Health $27 278%
Kern Family Health Care $27 278%
Dignity Health Central Coast $31 - $198 319%
Community Health $35 - $219 360%
Physicians Choice Medical Group $35 - $223 360%
Stanislaus Partners In Health $35 - $219 360%
Health Plan Of San Joaquin $38 - $239 391%
Fowler Packing $39 - $247 402%
Dignity (Formerly Managed Care Systems) $40 - $251 412%
Kern Legacy $41 - $259 422%
Aetna $42 - $267 433%
Blue Shield $42 - $303 433%
UnitedHealthcare $42 - $284 433%
Bakersfield Family Medical Group $47 - $299 484%
First Health Formerly Coventry $47 - $295 484%
Network By Design $49 - $309 505%
Community Care Health Plan $50 - $319 515%
Health Smart $50 - $319 515%
Key Medical Ipa $50 - $319 515%
Sutter Health $53 - $339 546%
Multiplan $60 - $382 618%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens