CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Lexington Memorial Hospital Inc

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $51
  • Cash Discount Price: $58
  • vs. Medicare Baseline: 5.25x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Lexington Memorial Hospital Inc is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 5.25x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.
Cash / Self-Pay
$58

Average discount available for prompt cash payment at this facility.

Insurance Median
$51

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: $58 (597%)
Insurance Median: $51 (525%)
Cash: $58 (597% of Medicare)
Ins. Median: $51 (525% 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 525% of the Medicare baseline (a markup of 425%). 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
Amerihealth $17 - $18 175%
Blue Cross Blue Shield $17 - $27 175%
Alliance $18 185%
Ambetter / Centene $18 185%
Carolina Complete $18 185%
Healthy Blue $18 185%
Partners $18 185%
Trillium $18 185%
UnitedHealthcare $18 - $52 185%
Vaya $18 185%
Wellcare $18 185%
Medcost $25 - $78 257%
Aetna $33 - $107 340%
Oscar $37 - $51 381%
Cigna $50 - $51 515%
Directnet $69 711%
Healthgram Lexington Home Brands $84 865%
Healthgram $93 958%
Private Healthcare Systems $95 978%
Beechstreet $102 1050%
Humana $102 1050%
Multiplan $104 1071%
National Provider Network $104 1071%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Hospital Drive Po Box 1817, Lexington, NC 27293
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals