CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Pinckneyville Community Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $62
Cash Discount Price: $117
vs. Medicare Baseline: 6.39x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Pinckneyville Community Hospital is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 6.39x the Medicare baseline. Located in 5383 State Route 154, Pinckneyville, IL.

Cash / Self-Pay

$117

Average discount available for prompt cash payment at this facility.

Insurance Median

$62

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: $117 (1205%)

Insurance Median: $62 (639%)

Cash: $117 (1205% of Medicare)

Ins. Median: $62 (639% 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 639% of the Medicare baseline (a markup of 539%). 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
Aetna	$24 - $143	247%
Ambetter / Centene	$24	247%
Blue Cross Blue Shield	$24 - $114	247%
Medicaid / KanCare	$24	247%
Humana	$28 - $59	288%
Umwa Mcr Adv - All Plans	$28 - $59	288%
UnitedHealthcare	$28 - $130	288%
Wellcare Mcr Adv - All Plans	$28 - $59	288%
Healthlink Hmo	$59 - $125	608%
Cigna	$62 - $131	639%
Healthlink Ppo - All Other Plans	$62 - $131	639%
Healthlink Work Comp	$62 - $131	639%
Phcs - All Other Plans	$62 - $130	639%
Phcs Savility	$64 - $135	659%
Multiplan - All Plans	$68 - $143	700%

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 $117.
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 Pinckneyville Community Hospital 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.