CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Hamilton Memorial Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $93
  • Cash Discount Price: $99
  • vs. Medicare Baseline: 9.58x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Hamilton Memorial Hospital is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 9.58x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.
Cash / Self-Pay
$99

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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: $99 (1020%)
Insurance Median: $93 (958%)
Cash: $99 (1020% of Medicare)
Ins. Median: $93 (958% 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 958% of the Medicare baseline (a markup of 858%). 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 $43 - $47 443%
Blue Cross Blue Shield $44 - $106 453%
Aetna $47 - $105 484%
Health Alliance $47 - $93 484%
Humana $47 484%
Medicare (plans) $47 484%
UnitedHealthcare $47 - $83 484%
Wellcare $47 484%
Alliance Coal $82 844%
Healthscope $82 844%
Wellfirst (Ssmhic) $82 844%
Hope Trust $87 896%
Cigna $91 937%
Hfn, Inc $93 - $105 958%
Healthlink $99 - $105 1020%
Multiplan $99 1020%
Siho $105 1081%
Three Rivers Provider $105 1081%
Healthsmart $111 1143%
Stratose $111 1143%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 S Marshall Avenue, McLeansboro, IL 62859
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals