CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Clay County Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $130
  • Cash Discount Price: $210
  • vs. Medicare Baseline: 13.39x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Clay County Hospital is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $210. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 13.39x the Medicare baseline. Located in 911 Stacy Burk Dr, Flora, IL.
Cash / Self-Pay
$210

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: $210 (2163%)
Insurance Median: $130 (1339%)
Cash: $210 (2163% 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
Blue Cross Blue Shield $4 - $154 41%
UnitedHealthcare $8 - $168 82%
Aetna $57 - $166 587%
Ambetter / Centene $57 587%
Medica(Wellfirst) $57 - $130 587%
Meridian $57 587%
Wellcare $57 587%
Healthlink $136 - $168 1401%
Cigna $168 1730%
Usa Mco $200 2060%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 911 Stacy Burk Dr, Flora, IL 62839
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals