CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: West Valley Medical Center

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $114
Cash Discount Price: $307
vs. Medicare Baseline: 11.74x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at West Valley Medical Center is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $307. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 11.74x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.

Cash / Self-Pay

$307

Average discount available for prompt cash payment at this facility.

Insurance Median

$114

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: $307 (3162%)

Insurance Median: $114 (1174%)

Cash: $307 (3162% of Medicare)

Ins. Median: $114 (1174% 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 1174% of the Medicare baseline (a markup of 1074%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$8 - $1,020	82%
Molina	$8 - $10	82%
Humana	$10 - $258	103%
Regence Blue Shield	$10	103%
St Luke'S Health Partners	$10	103%
United	$10 - $184	103%
Veteran'S Administration	$10	103%
Regence	$20	206%
Select Health Idaho (Eirmc Only)	$98	1009%
Corizon Health	$114	1174%
True Blue	$121	1246%
Cigna	$172	1771%
Pacificsource Health	$184	1895%
Moda	$192	1977%
Aetna	$243	2503%
Four Rivers Hospice	$246	2533%
Multiplan	$246	2533%
Geha Ppo Usa	$261	2688%
Coventry First Health	$277	2853%
St Alphonsus Health	$277	2853%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $307.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 83036.

Insurance In-Network Protection Plan

Contact your insurance company to confirm West Valley Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 83036.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.