CMS Price Transparency Data
Blood test, average blood sugar (A1c)
Facility: Mercy Hospital Carthage
Billing Code: 83036 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 83036
- Insurance Median: $83
- Cash Discount Price: $87
- vs. Medicare Baseline: 8.55x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Mercy Hospital Carthage is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 8.55x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.
Cash / Self-Pay
$87
Average discount available for prompt cash payment at this facility.
Insurance Median
$83
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: $87 (896%)
Insurance Median: $83 (855%)
Cash: $87 (896% of Medicare)
Ins. Median: $83 (855% 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 855% of the Medicare baseline (a markup of 755%). 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.
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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 | $9 - $125 | 93% |
| Humana | $9 - $42 | 93% |
| Medicaid / KanCare | $9 - $77 | 93% |
| Blue Cross Blue Shield | $10 - $39 | 103% |
| Medicare (plans) | $10 - $41 | 103% |
| UnitedHealthcare | $13 - $122 | 134% |
| United Medical Resources Contracted [320454] | $14 - $126 | 144% |
| Cherokee Nation Health Serv Contracted [320066] | $35 - $38 | 360% |
| Cigna | $35 - $126 | 360% |
| Cross Timbers Hospice [20098] | $35 - $38 | 360% |
| Dept Of Veteran Affairs Contracted [320106] | $35 - $38 | 360% |
| Elara Caring Aspire Hospice [20433] | $35 - $38 | 360% |
| Globalhealth Contracted [320145] | $35 - $38 | 360% |
| Halo Hcr Inc Hospice Contracted [320432] | $35 - $38 | 360% |
| Halo Hcr Inc Hospice [20432] | $35 - $38 | 360% |
| Indian Health Service Contracted [320198] | $35 - $38 | 360% |
| Kindful Hospice Contracted [320434] | $35 - $38 | 360% |
| Kindful Hospice [20434] | $35 - $38 | 360% |
| Medical Associates Health Contracted [320444] | $35 - $38 | 360% |
| Mercy Hospice Okc [20252] | $35 - $38 | 360% |
| Mercy Mgd Behavioral Health Contracted [320259] | $35 - $38 | 360% |
| Pace Of The Ozarks Contracted [320518] | $35 - $38 | 360% |
| Provider Partners Health Plans Contracted [320450] | $35 - $38 | 360% |
| Qual Choice Contracted [320325] | $35 - $38 | 360% |
| Tricare | $35 - $39 | 360% |
| Point C Contracted [320238] | $45 - $126 | 463% |
| Health Systems Inc Contracted [320174] | $55 - $60 | 566% |
| Insurance System Inc Contracted [320465] | $55 - $60 | 566% |
| Administrative Payor Contracted [320005] | $58 - $63 | 597% |
| Centivo Contracted [320505] | $59 - $64 | 608% |
| Healthscope Contracted [320182] | $67 - $73 | 690% |
| Ambetter / Centene | $70 - $77 | 721% |
| Home State Health Plan Contracted [320187] | $70 - $77 | 721% |
| Novasys Contracted [320285] | $70 - $77 | 721% |
| Benefit Management Contracted [320052] | $77 - $122 | 793% |
| Auxiant Contracted [320462] | $83 - $119 | 855% |
| Healthlink Contracted [320179] | $83 - $130 | 855% |
| Preferred Health Plan Contracted [320522] | $83 - $91 | 855% |
| Workers Comp [20426] | $102 - $140 | 1050% |
| 90 Degree Benefits Contracted [320436] | $109 - $119 | 1123% |
| Aither Health Contracted [320449] | $109 - $119 | 1123% |
| Ebms Contracted [320493] | $109 - $119 | 1123% |
| Edison Health Solutions Contracted [320502] | $109 - $119 | 1123% |
| Imagine 360 Contracted [320494] | $109 - $119 | 1123% |
| Mercy Benefit Admin Contracted [320251] | $109 - $126 | 1123% |
| Reflect Health Contracted [320492] | $109 - $119 | 1123% |
| Show-Me Health Administrators Contracted [320483] | $109 - $119 | 1123% |
| Yuzu Health Contracted [320521] | $109 - $119 | 1123% |
| Evolutions Health Care Contracted [320124] | $111 - $122 | 1143% |
| First Health Contracted [320128] | $111 - $122 | 1143% |
| Medica Contracted [320239] | $111 - $121 | 1143% |
| Multiplan Contracted [320270] | $111 - $122 | 1143% |
| Private Health Care Systems Contracted [320320] | $111 - $122 | 1143% |
| American Healthcare Alliance Contracted [320020] | $115 - $126 | 1184% |
| Ppo Plus Contracted [320310] | $115 - $126 | 1184% |
| Usa Managed Care Org Contracted [320429] | $115 - $126 | 1184% |