CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Boston Children's Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $119
Cash Discount Price: $168
vs. Medicare Baseline: 12.26x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Boston Children's Hospital is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 12.26x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$168

Average discount available for prompt cash payment at this facility.

Insurance Median

$119

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: $168 (1730%)

Insurance Median: $119 (1226%)

Cash: $168 (1730% of Medicare)

Ins. Median: $119 (1226% 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 1226% of the Medicare baseline (a markup of 1126%). 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	$34 - $111	350%
Unicare	$38	391%
Cdphp	$82 - $143	844%
Harvard Pilgrim	$85 - $114	875%
United	$100 - $140	1030%
Aetna	$101 - $141	1040%
Mgb/Allways	$102 - $124	1050%
Tufts Public Plan	$103	1061%
Ambetter / Centene	$106	1092%
United Ri Nj Ny	$106	1092%
Carelon Strategies/Bhs	$109	1123%
UnitedHealthcare	$109 - $143	1123%
Carelon/Beacon	$126	1298%
Fallon	$128 - $130	1318%
Health New England	$136	1401%
Cigna	$143 - $152	1473%
Ets/Lifetrac	$143	1473%
Interlink Transplant	$143	1473%
Community Health Options	$151	1555%
Humana	$151	1555%
Coventry/Hcvm/First Health	$155	1596%
Multiplan/Phcs	$155 - $160	1596%

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 $168.
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 Boston Children's 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.