CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Licking Memorial Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $29
  • Cash Discount Price: $74
  • vs. Medicare Baseline: 2.99x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Licking Memorial Hospital is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 2.99x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$74

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $74 (762%)
Insurance Median: $29 (299%)
Cash: $74 (762% of Medicare)
Ins. Median: $29 (299% 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 299% of the Medicare baseline (a markup of 199%). 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
Aetna $10 - $84 103%
Blue Cross Blue Shield $10 - $100 103%
Champva [500001] $10 103%
Cigna $10 - $105 103%
Humana $10 - $113 103%
Medicare (plans) $10 103%
Tricare $10 103%
UnitedHealthcare $10 - $99 103%
Veterans Administration [100068] $10 103%
Wellcare By Allwell [450104] $10 103%
Molina Marketplace [100106] $16 165%
Medical Mutual [100114] $18 - $96 185%
Allied Benefit Systems [100015] $23 - $84 237%
Geha [100039] $23 - $84 237%
Gravie Administrative Services [100165] $23 - $84 237%
Medben [700068] $23 - $114 237%
Meritain [100063] $23 - $84 237%
Optima [700069] $23 - $84 237%
Trustmark Small Business Benefits [100263] $23 - $84 237%
Webtpa [100127] $23 - $84 237%
Benicomp [70090] $24 - $87 247%
Consociate Health 6 Degrees [100059] $26 - $93 268%
Consociate Health [100029] $26 - $93 268%
Healthscope [100157] $28 - $99 288%
Surest [100016] $28 - $99 288%
United Medical Resources [700071] $28 - $99 288%
American Postal Workers [100089] $29 - $105 299%
Antidote Health Plan Of Ohio [70006803] $29 - $105 299%
Coresource [100002] $29 - $116 299%
Great West Life [700064] $29 - $105 299%
National Association Of Letter Carriers [100067] $29 - $105 299%
Ohio Healthy Luminare Health [100264] $29 - $105 299%
Ohio Healthy [100255] $29 - $105 299%
Ohio Ppo Connect [70006801] $29 - $105 299%
Osu Prime Care [100254] $29 - $105 299%
Quality Care Partners [70006802] $29 - $105 299%
The Health Plan [100261] $29 - $105 299%
Wellfleet Group, Llc [100164] $29 - $105 299%
Coventry [100010] $30 - $107 309%
Pan American Life [700070] $30 - $107 309%
Ohio Health Choice [100109] $31 - $112 319%
Administrative Concepts [100006] $32 - $113 330%
Carefactor [100087] $32 - $113 330%
Philadelphia American Life [100260] $32 - $116 330%
Reliance Standard-Asrm [100258] $32 - $113 330%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals