CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Nemours Children's Hospital, Delaware

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $115
  • Cash Discount Price: $205
  • vs. Medicare Baseline: 11.84x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Nemours Children's Hospital, Delaware is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $205. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 11.84x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$205

Average discount available for prompt cash payment at this facility.

Insurance Median
$115

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: $205 (2111%)
Insurance Median: $115 (1184%)
Cash: $205 (2111% of Medicare)
Ins. Median: $115 (1184% 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 1184% of the Medicare baseline (a markup of 1084%). 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
Priority Partners John Hopkins $10 - $101 103%
Tricare $10 103%
Us Family Health Plan $11 113%
Celtic Transplant $17 - $205 175%
Keystone First Hlth Plan $41 - $91 422%
Amerihealth Caritas Delaware $63 - $117 649%
Blue Cross Blue Shield $63 - $181 649%
Celtic Transplant For De First Health $72 742%
Delaware First Health $74 762%
UnitedHealthcare $75 - $128 772%
Wellpoint Maryland $76 783%
Kidz Partners $78 803%
Health Partners $80 824%
Upmc $81 834%
Fidelis $82 844%
Aetna $87 - $119 896%
Six Degrees Health Transplant $102 1050%
Cigna $113 - $129 1164%
Great West-One Health Plan $113 - $129 1164%
Ambetter / Centene $117 1205%
Geisinger Health Plan $123 1267%
Integra Administrative Group $123 1267%
National Transplant Network (Ntn) $133 1370%
Six Degrees Health $133 1370%
Star Healthcare Network $133 1370%
Life Trac Solid Organ And Bmt Transplant $144 1483%
First Health Network $195 2008%
Insurance Administrators Of America $195 2008%
Interlink Transplant Network $195 2008%
Multiplan $195 2008%
Preferred Healthcare $195 2008%
Private Healthcare Systems $195 2008%
Three Rivers Provider Network $195 2008%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens