CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Pender Memorial Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $80
  • Cash Discount Price: $58
  • vs. Medicare Baseline: 8.24x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Pender Memorial Hospital is $80. 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 8.24x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.
Cash / Self-Pay
$58

Average discount available for prompt cash payment at this facility.

Insurance Median
$80

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: $80 (824%)
Cash: $58 (597% of Medicare)
Ins. Median: $80 (824% 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 824% of the Medicare baseline (a markup of 724%). 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 $33 - $111 340%
Blue Cross Blue Shield $35 - $93 360%
Pace Of The Southern Piedmont $35 360%
Aetna $36 - $110 371%
Carolina Complete $36 371%
Cigna $36 - $57 371%
Nc Department Of Public Safety $36 - $70 371%
New Hanover Health $36 371%
Amerihealth $37 381%
Wellcare $37 381%
Ambetter / Centene $49 505%
Liberty Health $49 505%
Caresource North Carolina $52 536%
Plotkin Health $77 793%
UnitedHealthcare $94 968%
Medcost $97 - $108 999%
Employers Choice Network $125 1287%
Three Rivers Provider Network $125 1287%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 507 E Fremont St, Burgaw, NC 28425
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals