CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $71
  • Cash Discount Price: $95
  • vs. Medicare Baseline: 7.31x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Saint Joseph Regional Medical Center - Plymouth is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 7.31x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$95

Average discount available for prompt cash payment at this facility.

Insurance Median
$71

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: $95 (978%)
Insurance Median: $71 (731%)
Cash: $95 (978% of Medicare)
Ins. Median: $71 (731% 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 731% of the Medicare baseline (a markup of 631%). 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
Aetna $5 - $71 51%
Blue Cross Blue Shield $5 - $19 51%
Medicaid / KanCare $5 - $10 51%
UnitedHealthcare $5 - $93 51%
County Coroner $10 103%
Managed Health Services - Indiana $10 103%
Mdwise $10 103%
Medicare (plans) $10 103%
Meridian Complete $10 103%
Pace-Trinity Health $10 103%
Provider Partners Health Plan Of Indiana $11 113%
Auxiant $15 - $121 154%
Caresource $15 154%
Physicians Health Plan Northern Indiana Health Insurance $15 - $29 154%
St Joseph County Hlth Dpt $15 154%
Siho Insurance Services $16 165%
Key Benefit Administrator $17 - $102 175%
Allied Benefit Systems $18 - $95 185%
Blue Benefit Administrators Of Massachusetts $19 196%
Blue Care Network $19 196%
Blue Distinction Transplant $19 196%
Blue Shield - Ca $19 196%
Blue Shield - Id (Regence) $19 196%
Blue Shield - Ny Highmark Northeastern $19 196%
Blue Shield - Ny Highmark Western $19 196%
Blue Shield - Pa (Highmark) $19 196%
Blue Shield - Wa (Regence) $19 196%
Custom Design Benefits $21 216%
Plain Church Group $39 402%
Asr Health Benefits $71 731%
Christian Brother Services $71 731%
Employee Benefit Management $71 731%
Medical Mutual $71 731%
Meritain $71 731%
Preferred One $71 731%
Rural Carrier Health Benefit Plan $71 731%
Webtpa $71 731%
Notre Dame Athletic Association $80 824%
Wc Notre Dame $80 824%
Luminare Health (Detroit) $83 - $88 855%
Ameriben $88 906%
Geha $93 958%
Healthscope $93 958%
Student Insurance Cma $93 958%
Encore Health $102 1050%
Indiana Criminal Justice Inst $102 1050%
Western & Southern Financial Group $102 1050%
Cigna $105 1081%
Group Administrators $105 1081%
Health Partners $105 1081%
Mvp $105 1081%
Prairie States $105 1081%
Priority Health $105 1081%
Professional Benefit Administrators $105 1081%
Sagamore Health Network $105 - $112 1081%
Sisco Benefits $105 1081%
Unified Group Services $105 1081%
Goshen Preferred Network $112 - $126 1153%
Signature Care $121 1246%
Allied National Global Care $131 1349%
Asrm - Reliance Standard Life Insurance $131 1349%
Avmed Health Plan $131 1349%
Christian Care Ministry $131 1349%
Dean Health $131 1349%
Fallon Health $131 1349%
Family Life Insurance Company $131 1349%
Freedom Life Insurance Company $131 1349%
Ghc Scw $131 1349%
International Benefit Administrators $131 1349%
Lifetime Benefit Solutions $131 1349%
Manhattan Life $131 1349%
Medi Share $131 1349%
Multiplan $131 1349%
Pai $131 1349%
Pan-American Life $131 1349%
Paramount Hmo $131 1349%
Phcs $131 1349%
Philadelphia American Life Insurance $131 1349%
Trinity Health Share $131 1349%
Bankers Life Casualty $146 1504%
Bureau Of Disability $146 1504%
Wc Align Network $146 1504%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1915 Lake Ave, Plymouth, IN 46563
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals