CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: West Kendall Baptist Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $181
  • Cash Discount Price: $309
  • vs. Medicare Baseline: 18.64x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at West Kendall Baptist Hospital is $181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $309. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 18.64x the Medicare baseline. Located in 9555 Sw 162 Ave, Miami, FL.
Cash / Self-Pay
$309

Average discount available for prompt cash payment at this facility.

Insurance Median
$181

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: $309 (3182%)
Insurance Median: $181 (1864%)
Cash: $309 (3182% of Medicare)
Ins. Median: $181 (1864% 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 1864% of the Medicare baseline (a markup of 1764%). 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
Aetna $3 - $381 31%
Amerigroup $3 31%
Medicaid / KanCare $3 31%
Sunshine State $3 31%
UnitedHealthcare $3 - $476 31%
Vista $3 31%
Wellcare $3 31%
Blue Cross Blue Shield $10 - $308 103%
Medica Health Plan $10 103%
Medicare (plans) $10 - $13 103%
Avmed $11 - $232 113%
Cigna $11 - $381 113%
Humana $11 113%
Leon Medical $11 113%
Non Contracted $175 1802%
Amerihealth $214 2204%
International $309 3182%
Dimension Health Plan $357 - $428 3677%
Affordable $428 4408%
Phcs $428 4408%
Quality Health $428 4408%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9555 Sw 162 Ave, Miami, FL 33196
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals