CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $130
  • Cash Discount Price: $107
  • vs. Medicare Baseline: 13.39x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at HSHS St Elizabeth's Hospital is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 13.39x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$107

Average discount available for prompt cash payment at this facility.

Insurance Median
$130

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: $107 (1102%)
Insurance Median: $130 (1339%)
Cash: $107 (1102% of Medicare)
Ins. Median: $130 (1339% 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 1339% of the Medicare baseline (a markup of 1239%). 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
Meridian Health Plan $4 41%
Molina Healthcare $4 - $10 41%
Aetna $10 - $118 103%
Blue Cross Blue Shield $10 - $168 103%
Clear Spring Health Of Illinois $10 103%
Health Alliance Medical Plans $10 - $143 103%
Health Partners $10 103%
Humana $10 103%
Sae Hospice $10 103%
UnitedHealthcare $10 - $168 103%
Celtic Insurance Company $21 216%
Naphcare $22 227%
Claim Doc $24 247%
Hopetrust $24 247%
Amish Community $36 - $47 371%
Wellfirst $84 - $108 865%
First Health $97 - $125 999%
Cigna $103 - $168 1061%
Healthlink $103 - $168 1061%
Caterpillar, Inc. $104 - $135 1071%
Consociate Group $114 - $148 1174%
Choicecare $117 - $151 1205%
Healthcare Finest Network (Hfn) $117 - $151 1205%
Multiplan/Phcs $117 - $151 1205%
Provider Network Of America $117 - $151 1205%
City Of Springfield $130 - $168 1339%
Current Health Solutions $130 - $168 1339%
Healthscope $130 - $168 1339%
Illinois Breast And Cervical Cancer Program $130 - $168 1339%
Interplan $130 - $168 1339%
Live360 $130 - $168 1339%
Wexford $130 - $168 1339%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals