CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Decatur Memorial Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $118
  • Cash Discount Price: $254
  • vs. Medicare Baseline: 12.15x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Decatur Memorial Hospital is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 12.15x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.
Cash / Self-Pay
$254

Average discount available for prompt cash payment at this facility.

Insurance Median
$118

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: $254 (2616%)
Insurance Median: $118 (1215%)
Cash: $254 (2616% of Medicare)
Ins. Median: $118 (1215% 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 1215% of the Medicare baseline (a markup of 1115%). 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
Medicaid / KanCare $6 62%
Blue Cross Blue Shield $9 - $254 93%
Aetna $10 - $170 103%
Coventry $10 - $129 103%
Health Alliance $10 - $169 103%
Humana $10 - $165 103%
Medicare (plans) $10 103%
Tricare $10 103%
UnitedHealthcare $10 - $254 103%
Veterans Administration $10 103%
Wellcare $10 103%
Caterpillar $12 124%
Plain Church Medical Group $13 - $114 134%
Illinois Workers Compensation $50 - $84 515%
Hfn $79 - $190 814%
Commercial Workers Compensation $80 824%
Mennonite Churches $89 917%
Health Alliance Mh Employee Plan $117 1205%
Cigna $118 1215%
6 Degrees Health $152 1565%
Hopetrust $152 1565%
Hst $152 1565%
Phcs Savility $165 1699%
Phcs Multiplan Ppo $173 1782%
Healthlink $174 1792%
Corvel $183 1885%
Consociate $188 1936%
Liability $254 2616%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 North Edward Street, Decatur, IL 62526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals