CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Madison County Health Care System

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $63
  • Cash Discount Price: $78
  • vs. Medicare Baseline: 6.49x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Madison County Health Care System is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 6.49x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$78

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $78 (803%)
Insurance Median: $63 (649%)
Cash: $78 (803% of Medicare)
Ins. Median: $63 (649% 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 649% of the Medicare baseline (a markup of 549%). 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 $42 - $63 433%
Medical Associates Hp - All Plans $42 433%
Medigold-All Plans $42 433%
Tricare $42 433%
UnitedHealthcare $42 - $87 433%
American Hp Mcr Adv-All Plans $44 453%
Blue Cross Blue Shield $46 - $50 474%
Iowa Total Care Mcaid-All Plans $46 474%
Molina Mcaid/Chip -All Plans $47 484%
Amerigroup Mcaid-All Plans $48 494%
Madison County Sheriff-All Plans $48 494%
Oscar - All Plans $63 649%
Corvel Wc-All Plans $87 896%
Choicecare-All Plans $92 947%
First Choice-All Plans $92 947%
First Health-All Plans $92 947%
Integrated Hp-All Plans $92 947%
Mutual Of Omaha-All Plans $92 947%
Plaines Health-All Plans $92 947%
Preferred Hlth Ntwork-All Plans $92 947%
Principal Healthcare-All Plans $92 947%
Usa Managed Care-All Plans $92 947%
Medimore Employee Hp - All Plans $95 978%
Midlands Choice - All Plans $95 978%
Benefit Admin Of America-All Plans $97 999%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals