CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Northwest Health - Porter

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $125
  • Cash Discount Price: $103
  • vs. Medicare Baseline: 12.87x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Northwest Health - Porter is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 12.87x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
$103

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $103 (1061%)
Insurance Median: $125 (1287%)
Cash: $103 (1061% of Medicare)
Ins. Median: $125 (1287% 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 1287% of the Medicare baseline (a markup of 1187%). 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 $7 - $15 72%
Tricare $9 93%
UnitedHealthcare $9 - $39 93%
Aetna $10 - $176 103%
Care Improvement Plus $10 103%
Caresource $10 103%
Healthy Indiana Plan $10 103%
Humana $10 103%
In Dept Of Correction $10 103%
Managed Health Services $10 - $19 103%
Medicaid / KanCare $10 103%
Medicare (plans) $10 103%
Mhs $10 103%
Node Devoted Health Mcr Adv $10 103%
Node Hospice Non Par Agree $10 103%
Node Mhs Mcr Adv $10 103%
Node Va $10 103%
Veterans Eval Services $10 103%
Node Us Dept Of Labor $12 124%
Align Network $16 165%
One Call Work Comp $16 165%
Encore Health $17 - $278 175%
Prime Health $17 - $260 175%
Indiana Work Comp $19 196%
Lutheran Preferred $19 - $208 196%
Node Encore Kba Epo $23 237%
Porter County $23 237%
Preferred Network Access $23 237%
Magnacare Ma $25 257%
Lutheran Preferred Chs Employees $75 - $83 772%
Self Pay $84 - $125 865%
Cigna $86 - $96 886%
Physicians Health Plan $119 - $133 1226%
Php Freedom $128 - $143 1318%
Sagamore Health Network $137 - $205 1411%
First Health Coventry $152 - $170 1565%
Encore Ppo $156 - $174 1607%
Southeastem Indiana Health Operations $218 - $260 2245%
Network Synergy Group $233 - $260 2400%
Multiplan/Phcs $261 - $291 2688%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals