CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Harlem Hospital Center

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $39
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.02x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Harlem Hospital Center is $39. 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 4.02x the Medicare baseline. Located in 506 Lenox Avenue, New York, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $39 (402%)
Ins. Median: $39 (402% 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 402% of the Medicare baseline (a markup of 302%). 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 $7 - $28 72%
Healthfirst $8 - $88 82%
Elderplan $10 103%
Fidelis $10 - $88 103%
Magnacare $12 124%
Oxford $14 144%
United $14 - $49 144%
Oscar $15 154%
Centerlight $20 206%
Cigna $24 247%
Wellcare $24 247%
Carelon $26 - $39 268%
Emblem $28 - $53 288%
Blue Cross Blue Shield $32 - $88 330%
Multiplan $33 340%
Local 1199 $35 360%
Villagecare Max $35 360%
Vnsny $35 - $40 360%
Metroplus $38 - $88 391%
Amidacare $39 402%
Senior Whole Health $39 402%
United Behavioral Health $39 - $43 402%
Affinity $40 - $88 412%
Carelon (Amida Care) $40 412%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 506 Lenox Avenue, New York, NY 10037
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals