CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: St James Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $74
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 7.62x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at St James Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 7.62x the Medicare baseline. Located in 400 S Clark St, Butte, MT.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$74

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%)
Insurance Median: $74 (762%)
Ins. Median: $74 (762% 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 762% of the Medicare baseline (a markup of 662%). 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
Humana $10 103%
UnitedHealthcare $10 - $72 103%
Coastal Administrative Services $20 206%
Allegiance $24 - $80 247%
Cigna $41 - $80 422%
First Choice Health $45 - $76 463%
Ebms-Employee Benefit Mng $51 - $76 525%
Pacificsource $55 - $80 566%
Geha $67 - $72 690%
Mt Health Co-Op $71 - $77 731%
Blue Cross Blue Shield $73 - $84 752%
Aetna $75 - $80 772%
Interwest $75 - $80 772%
Meritain Health $75 - $80 772%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 S Clark St, Butte, MT 59701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals