CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Legacy Mount Hood Medical Center

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $18
Cash Discount Price: $7
vs. Medicare Baseline: 1.85x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Legacy Mount Hood Medical Center is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 1.85x the Medicare baseline. Located in 24800 Se Stark Street, Gresham, OR.

Cash / Self-Pay

Average discount available for prompt cash payment at this facility.

Insurance Median

$18

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: $7 (72%)

Insurance Median: $18 (185%)

Cash: $7 (72% of Medicare)

Ins. Median: $18 (185% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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 - $18	103%
Atrio	$10	103%
Careoregon	$10	103%
Healthnet	$10 - $25	103%
Kaiser	$10	103%
Ageright	$11	113%
Moda	$11 - $38	113%
Pacificsource	$19 - $22	196%
Cigna	$35	360%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $7.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 83036.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Legacy Mount Hood Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 83036.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.