CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Sanford Sheldon Medical Center

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $55
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 5.66x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Sanford Sheldon Medical Center is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 5.66x the Medicare baseline. Located in 118 North Seventh Avenue, Po Box 250, Sheldon, IA.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $69 (711%)
Insurance Median: $55 (566%)
Cash: $69 (711% of Medicare)
Ins. Median: $55 (566% 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 566% of the Medicare baseline (a markup of 466%). 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
Sanford Health Plan Align $25 257%
Ucare $26 - $76 268%
Aetna $27 - $75 278%
Blue Cross Blue Shield $27 278%
Health Partners $27 - $64 278%
Medicare (plans) $27 278%
Primewest $27 278%
UnitedHealthcare $27 - $72 278%
Wellmark $43 - $45 443%
Sanford Health Plan $46 - $54 474%
Security Health Plan $47 484%
Medica $71 - $76 731%
First Choice Health Network $77 793%
Healthez $77 793%
Multiplan $77 793%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 118 North Seventh Avenue, Po Box 250, Sheldon, IA 51201
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals