CMS Price Transparency Data
Blood test, average blood sugar (A1c)
Facility: Mount Carmel East & West
Billing Code: 83036 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 83036
- Insurance Median: $43
- Cash Discount Price: $219
- vs. Medicare Baseline: 4.43x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Mount Carmel East & West is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $219. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 4.43x the Medicare baseline. Located in 6001 East Broad Street, Columbus, OH.
Cash / Self-Pay
$219
Average discount available for prompt cash payment at this facility.
Insurance Median
$43
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: $219 (2255%)
Insurance Median: $43 (443%)
Cash: $219 (2255% of Medicare)
Ins. Median: $43 (443% 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 443% of the Medicare baseline (a markup of 343%). 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 - $92 | 93% |
| Medicare (plans) | $9 - $59 | 93% |
| Rural Carrier Health Benefit Plan | $9 | 93% |
| Blue Benefit Administrators Of Massachusetts | $10 - $212 | 103% |
| Blue Care Network | $10 - $212 | 103% |
| Blue Cross Blue Shield | $10 - $212 | 103% |
| Blue Distinction Transplant | $10 - $212 | 103% |
| Blue Shield - Ca | $10 - $212 | 103% |
| Blue Shield - Id (Regence) | $10 - $212 | 103% |
| Blue Shield - Ny Highmark Northeastern | $10 - $212 | 103% |
| Blue Shield - Ny Highmark Western | $10 - $212 | 103% |
| Blue Shield - Pa (Highmark) | $10 - $212 | 103% |
| Blue Shield - Wa (Regence) | $10 - $212 | 103% |
| Hospice Mount Carmel | $10 - $56 | 103% |
| Oscar | $10 - $92 | 103% |
| The Health Plan | $10 - $60 | 103% |
| UnitedHealthcare | $10 - $183 | 103% |
| Medical Mutual | $18 - $194 | 185% |
| Enterprise Group Planning | $19 - $108 | 196% |
| Custom Design Benefits | $20 - $117 | 206% |
| Quality Care Partners | $22 - $126 | 227% |
| Western & Southern Financial Group | $25 - $194 | 257% |
| American Postal Workers Secondary | $40 | 412% |
| Cigna | $40 | 412% |
| Health Partners | $40 | 412% |
| Healthgram | $40 | 412% |
| Mvp | $40 | 412% |
| Priority Health | $40 | 412% |
| Geha | $41 - $183 | 422% |
| Gravie Admin Services | $41 | 422% |
| Healthez | $41 | 422% |
| Meritain | $41 | 422% |
| Webtpa | $41 | 422% |
| Access Health | $43 | 443% |
| Acclaim | $43 | 443% |
| Administrative Concepts | $43 | 443% |
| Allegeant | $43 | 443% |
| Allied Benefit Systems | $43 | 443% |
| American Family | $43 | 443% |
| American Healthcare Alliance | $43 | 443% |
| American National | $43 | 443% |
| American Republic | $43 | 443% |
| Amerihealth | $43 | 443% |
| Aultcare | $43 | 443% |
| Automated Benefit Services | $43 | 443% |
| Auxiant | $43 | 443% |
| Benefit Administrative Systems,Llc | $43 | 443% |
| Boon Chapman | $43 | 443% |
| Cam Administrative Services | $43 | 443% |
| Christian Brother Services | $43 | 443% |
| Christian Brothers Holy Cross | $43 | 443% |
| Claimchoice Adminstrators | $43 | 443% |
| Comprehensive Benefits | $43 | 443% |
| Continental Life Insurance | $43 | 443% |
| Coventry | $43 | 443% |
| Custom Benefit Administrators | $43 | 443% |
| Cypress Benefit Administrators | $43 | 443% |
| Employee Benefit Concepts | $43 | 443% |
| Employee Benefit Management | $43 | 443% |
| Forest County Potawatomi | $43 | 443% |
| Freedom Life Insurance Company | $43 | 443% |
| Group Administrators | $43 | 443% |
| Group Marketing Services | $43 | 443% |
| Group Pension Administrators | $43 | 443% |
| Guardian | $43 | 443% |
| Health America | $43 | 443% |
| Health Choices | $43 | 443% |
| Healthcare Management Admin | $43 | 443% |
| Insight | $43 | 443% |
| Intercare | $43 | 443% |
| Jfp Benefit Management | $43 | 443% |
| Jp Farley Corporation | $43 | 443% |
| Key Benefit Administrator | $43 | 443% |
| Liberty Union Life Assurance Co | $43 | 443% |
| Lucent Health | $43 | 443% |
| Luminare Health | $43 | 443% |
| Magnacare | $43 | 443% |
| Medcost | $43 | 443% |
| Mutual Health Services | $43 | 443% |
| Mutual Of Omaha | $43 | 443% |
| Ncas | $43 | 443% |
| Nippon Life Ins | $43 | 443% |
| Nova | $43 | 443% |
| Painters Union Insurance Fund | $43 | 443% |
| Physicians Mutual | $43 | 443% |
| Plumbers Local 98 Insurance Fund | $43 | 443% |
| Prairie States | $43 | 443% |
| Preferred One | $43 | 443% |
| Primary Physician Care | $43 | 443% |
| Professional Benefit Administrators | $43 | 443% |
| Secureone Preferred United Plans | $43 | 443% |
| Siho Insurance Services | $43 | 443% |
| Sisco Benefits | $43 | 443% |
| The Loomis Company | $43 | 443% |
| Trustmark Small Business Benefits | $43 | 443% |
| U Of M Health Plan | $43 | 443% |
| Unicare | $43 | 443% |
| Unified Group Services | $43 | 443% |
| Us Health And Life | $43 | 443% |
| Valenz | $43 | 443% |
| Varipro | $43 | 443% |
| Wps | $43 | 443% |
| Humana | $47 - $92 | 484% |
| First Health | $48 | 494% |
| Medben | $55 - $69 | 566% |
| Consociate | $56 | 577% |
| Health Ohio Network | $56 | 577% |
| Caresource | $67 | 690% |
| Healthlink Inc | $69 | 711% |
| Medical Benefits Mutual | $69 | 711% |
| Ohio Health Choice | $69 | 711% |
| Ohio Ppo Connect | $69 | 711% |
| Ameriben | $74 | 762% |
| Luminare Health (Detroit) | $74 | 762% |
| Medi Share | $74 | 762% |
| Multiplan | $74 | 762% |
| Ohiohealthy | $74 | 762% |
| Osu Not Independent Choice | $74 | 762% |
| Phcs | $74 | 762% |
| Philadelphia American Life Insurance | $74 | 762% |
| Twin Valley Psychiatric | $74 | 762% |
| Health Smart | $78 | 803% |
| Bccp | $92 | 947% |
| Medicaid / KanCare | $92 | 947% |
| Optima Health | $92 | 947% |
| Crime Victim Assistance | $632 | 6509% |
| Ohio Safe Program | $632 | 6509% |