CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Southwest General Health Center

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $37
  • Cash Discount Price: $54
  • vs. Medicare Baseline: 3.81x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Southwest General Health Center is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 3.81x the Medicare baseline. Located in 18697 Bagley Road, Middleburg Heights, OH.
Cash / Self-Pay
$54

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

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: $54 (556%)
Insurance Median: $37 (381%)
Cash: $54 (556% of Medicare)
Ins. Median: $37 (381% 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 381% of the Medicare baseline (a markup of 281%). 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
Medical Mutual $4 - $5 41%
Medical Mutual-Ohio $4 41%
Healthsmart $10 - $37 103%
Health Design Plus $11 - $43 113%
Clarity Health $12 - $46 124%
Healthspan $12 - $46 124%
Humana $12 - $57 124%
Buckeye $13 - $57 134%
Molina $13 - $57 134%
Healthsmart Preferred $14 - $52 144%
Ohio Health Choice Plus $15 - $56 154%
Aetna $16 - $62 165%
Summacare $16 - $62 165%
UnitedHealthcare $16 - $62 165%
Coventry $21 - $79 216%
First Health $21 - $79 216%
Cigna $22 227%
Ohio Health Choice $23 - $89 237%
Private Healthare Systems $24 - $92 247%
Amerihealth Caritas $57 587%
Blue Cross Blue Shield $57 587%
Caresource $57 587%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 18697 Bagley Road, Middleburg Heights, OH 44130
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals