CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Woodlawn Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $33
Cash Discount Price: $111
vs. Medicare Baseline: 3.40x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Woodlawn Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 3.40x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $111 (1143%)

Insurance Median: $33 (340%)

Cash: $111 (1143% of Medicare)

Ins. Median: $33 (340% 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 340% of the Medicare baseline (a markup of 240%). 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
Blue Cross Blue Shield	$7 - $112	72%
Caresource Mcaid Hww	$10	103%
Mdwise Excel Hhw & Hcc	$10	103%
Mhs Mcaid Hcc	$10	103%
Mhs Mcaid Hhw	$10	103%
UnitedHealthcare	$10 - $112	103%
Partners Direct Health-All Plans	$14	144%
Aetna	$33 - $141	340%
Caresource Mcaid Hip	$33	340%
Caresource Mcr Adv	$33	340%
Humana	$33 - $115	340%
Mdwise Mcaid Excel Hip	$33	340%
Mhs Exch Mrktplce-All Other Plans	$33	340%
Mhs Mcaid Hip	$33	340%
Mhs Mcr Adv	$33	340%
Caresource Exch - All Other Plans	$42	433%
Ambetter / Centene	$43	443%
Cigna	$106 - $126	1092%
Parkview Health Plans-All Plans	$111	1143%
Sagamore All Other Grps - All Other Plans	$124	1277%
Encore Comm-All Plans	$126	1298%
Phcs/Multiplan-All Plans	$138	1421%
Community Health Alliance-All Plans	$141	1452%

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 $111.
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 Woodlawn 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.