CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $12
Cash Discount Price: $86
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at UMass Memorial Healthalliance Hospitals is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 1.24x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$86

Average discount available for prompt cash payment at this facility.

Insurance Median

$12

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: $86 (886%)

Insurance Median: $12 (124%)

Cash: $86 (886% of Medicare)

Ins. Median: $12 (124% 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.

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
Institution [10406]	$9 - $46	93%
Masshealth [20302]	$9	93%
Medicaid / KanCare	$9 - $11	93%
Aetna	$10 - $56	103%
Blue Cross Blue Shield	$10 - $30	103%
Cigna	$10 - $37	103%
Commonwealth Care Mcr [10115]	$10	103%
Fallon Mcr Supp [20202]	$10	103%
Harvard Pilgrim Mcr [10106]	$10	103%
Medicare (plans)	$10	103%
Mgb Mcr [10124]	$10	103%
Senior Whole Health [10110]	$10	103%
Tufts Dual [10111]	$10	103%
Tufts Mcr [10112]	$10	103%
Tufts Us Family [11203]	$10	103%
UnitedHealthcare	$10 - $86	103%
Champva [11001]	$11	113%
Correctional Care [11003]	$13 - $15	134%
Workers Compensation [20501]	$14	144%
Tufts Connectorcare [10507]	$17	175%
Tufts [11201]	$21	216%
Harvard Pilgrim [10701]	$25 - $30	257%
Wellpoint [11112]	$25	257%
Hne [11108]	$48	494%
First Health Network [11120]	$64	659%
Multiplan [11109]	$64	659%
Fallon Connectorcare [10503]	$69	711%
Connecticare [11105]	$86	886%
Fallon Carelon Hlth [28]	$86	886%
Fallon Mcaid Carelon Hlth [29]	$86	886%
Grants [20507]	$86	886%
Hsno/Free Care [10801]	$294	3028%

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 $86.
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 UMass Memorial Healthalliance Hospitals 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.