CMS Price Transparency Data
Blood test, average blood sugar (A1c)
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 83036 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 83036
- Insurance Median: $22
- Cash Discount Price: $30
- vs. Medicare Baseline: 2.27x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Saint Alphonsus Medical Center Ontario is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 2.27x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$30
Average discount available for prompt cash payment at this facility.
Insurance Median
$22
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: $30 (309%)
Insurance Median: $22 (227%)
Cash: $30 (309% of Medicare)
Ins. Median: $22 (227% 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 227% of the Medicare baseline (a markup of 127%). 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 |
|---|---|---|
| Geha | $6 - $70 | 62% |
| UnitedHealthcare | $6 - $70 | 62% |
| Medicaid / KanCare | $7 - $25 | 72% |
| Oregon Screenwise | $8 - $22 | 82% |
| Cigna | $9 - $69 | 93% |
| Aetna | $10 - $69 | 103% |
| American Health Advantage Of Idaho | $10 | 103% |
| Asuris Northwest Health | $10 | 103% |
| Blue Cross Blue Shield | $10 - $62 | 103% |
| Blue Shield - Id (Regence) | $10 - $17 | 103% |
| Healthcare Management Admin | $10 - $16 | 103% |
| Healthnet | $10 | 103% |
| Medicare (plans) | $10 | 103% |
| Moda Health | $10 - $71 | 103% |
| Mountain Health Co-Op | $10 - $44 | 103% |
| Selecthealth | $10 - $66 | 103% |
| Pacificsource Health Plans | $14 - $69 | 144% |
| Ada County Jail Inmate Ins | $16 - $22 | 165% |
| Ambetter / Centene | $16 - $22 | 165% |
| Amish Mennonite | $16 - $22 | 165% |
| Bcccp-Michigan | $16 - $22 | 165% |
| Bccp | $16 - $22 | 165% |
| Bmc Healthnet | $16 - $22 | 165% |
| Breast Grant-Connecticut | $16 - $22 | 165% |
| California Health And Wellness | $16 - $22 | 165% |
| Cardinal Innovations Lme | $16 - $22 | 165% |
| Care Oregon Ohp | $16 - $22 | 165% |
| Cencal Health Plan | $16 - $22 | 165% |
| Cenpatico | $16 - $22 | 165% |
| Centurion Of Idaho | $16 - $22 | 165% |
| Chhuny | $16 - $22 | 165% |
| Childrens Comm Health Plan | $16 - $22 | 165% |
| Childrens Medical Services Title 19 | $16 - $22 | 165% |
| Community Benefit Health | $16 - $22 | 165% |
| Community Care Behavorial Health | $16 - $22 | 165% |
| Community Health Choice | $16 - $22 | 165% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $16 - $22 | 165% |
| Dean Wi Badgercare | $16 - $22 | 165% |
| Delaware First Health | $16 - $22 | 165% |
| Delta Dental Nj | $16 - $22 | 165% |
| Dph Tb Program | $16 - $22 | 165% |
| Dscc | $16 - $22 | 165% |
| Eastpointe Lme | $16 - $22 | 165% |
| Family Health Network | $16 - $22 | 165% |
| Freedom First Healthcare | $16 - $22 | 165% |
| Ghc Scw Wi Badgercare | $16 - $22 | 165% |
| Harbor Health | $16 - $22 | 165% |
| Health Safety Net | $16 - $22 | 165% |
| Healthy Blue Ne | $16 - $22 | 165% |
| Hennepin Health | $16 - $22 | 165% |
| Humana | $16 - $64 | 165% |
| Id County Ada | $16 - $22 | 165% |
| Id County Canyon | $16 - $22 | 165% |
| Id County Cat Fund | $16 - $22 | 165% |
| Id County Payette | $16 - $22 | 165% |
| Idaho Womens Health Check | $16 - $22 | 165% |
| Indiana Breast Cervical Cancer | $16 - $22 | 165% |
| Inland Empire Health Plan | $16 - $22 | 165% |
| Intercommunity Health Ohp | $16 - $22 | 165% |
| Iowa Total Care | $16 - $22 | 165% |
| Jai Medical System | $16 - $22 | 165% |
| Kern Family Health Plan | $16 - $22 | 165% |
| Keystone First | $16 - $22 | 165% |
| Keystone First Chip | $16 - $22 | 165% |
| La Care Health Plan | $16 - $22 | 165% |
| Lakeland Care Inc | $16 - $22 | 165% |
| Managed Health Services - Indiana | $16 - $22 | 165% |
| Maryland Breast & Cervical Program | $16 - $22 | 165% |
| Maryland Healthy Smiles - Scion Dental | $16 - $22 | 165% |
| Maryland Physicians Care | $16 - $22 | 165% |
| Massachusetts Behavioral Health Partnership | $16 - $22 | 165% |
| Mdwise | $16 - $22 | 165% |
| Medi-Cal | $16 - $22 | 165% |
| Medi-Cal Healthnet | $16 - $22 | 165% |
| Medstar Dc Healthy Family | $16 - $22 | 165% |
| Medstar Md Health Choice | $16 - $22 | 165% |
| Mo Home State Health Plan | $16 - $22 | 165% |
| Molina Centennial Care | $16 - $22 | 165% |
| Nascentia Health Options | $16 - $22 | 165% |
| Nebraska Total Care | $16 - $22 | 165% |
| New York Cancer Services Program | $16 - $22 | 165% |
| Nextlevel Health | $16 - $22 | 165% |
| Pace Of Southwest Michigan | $16 - $22 | 165% |
| Paramount Advantage | $16 - $22 | 165% |
| Parkland Community Health Plan | $16 - $22 | 165% |
| Partners Behavioral Lme | $16 - $22 | 165% |
| Peach State Healthplan | $16 - $22 | 165% |
| Presbyterian Centennial Care | $16 - $22 | 165% |
| Prestige Health Choice | $16 - $22 | 165% |
| Priority Partners | $16 - $22 | 165% |
| Rx 340B Pass Along | $16 - $22 | 165% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $16 - $22 | 165% |
| Rx Medi-Cal | $16 - $22 | 165% |
| Rx Meridian Rx | $16 - $22 | 165% |
| Sandhills Center Lme | $16 - $22 | 165% |
| Screening For Life | $16 - $22 | 165% |
| Sunshine State Health Plan | $16 - $22 | 165% |
| Superior Health | $16 - $22 | 165% |
| Tenncare | $16 - $22 | 165% |
| Texas Children'S Health Plan | $16 - $22 | 165% |
| Trillium Community Ohp | $16 - $22 | 165% |
| Tufts Health Public Plans | $16 - $22 | 165% |
| Vaya Health Lme | $16 - $22 | 165% |
| Wellsense Health Plan | $16 - $22 | 165% |
| Wi Womens Wellness | $16 - $22 | 165% |
| Blue Benefit Administrators Of Massachusetts | $17 | 175% |
| Blue Care Network | $17 | 175% |
| Blue Distinction Transplant | $17 | 175% |
| Blue Shield - Ca | $17 | 175% |
| Blue Shield - Ny Highmark Northeastern | $17 | 175% |
| Blue Shield - Ny Highmark Western | $17 | 175% |
| Blue Shield - Pa (Highmark) | $17 | 175% |
| Blue Shield - Wa (Regence) | $17 | 175% |
| Webtpa | $26 - $66 | 268% |
| Allegiance | $40 - $55 | 412% |
| Correctional Health Partners | $41 - $57 | 422% |
| Columbia Health Network | $42 - $58 | 433% |
| Allied National Global Care | $48 - $66 | 494% |
| Asrm - Reliance Standard Life Insurance | $48 - $66 | 494% |
| Christian Care Ministry | $48 - $66 | 494% |
| Dean Health | $48 - $66 | 494% |
| Fallon Health | $48 - $66 | 494% |
| Family Life Insurance Company | $48 - $66 | 494% |
| First Choice Health | $48 - $66 | 494% |
| Ghc Scw | $48 - $66 | 494% |
| International Benefit Administrators | $48 - $66 | 494% |
| Lifetime Benefit Solutions | $48 - $66 | 494% |
| Manhattan Life | $48 - $66 | 494% |
| Pai | $48 - $66 | 494% |
| Pan-American Life | $48 - $66 | 494% |
| Paramount Hmo | $48 - $66 | 494% |
| Phcs | $48 - $66 | 494% |
| Trinity Health Share | $48 - $66 | 494% |
| Lifewise | $49 - $68 | 505% |
| Allied Benefit Systems | $50 - $69 | 515% |
| Ameriben | $50 - $69 | 515% |
| Asr Health Benefits | $50 - $69 | 515% |
| Christian Brother Services | $50 - $69 | 515% |
| First Health | $50 - $69 | 515% |
| Healthez | $50 - $69 | 515% |
| Luminare Health (Detroit) | $50 - $69 | 515% |
| Medi Share | $50 - $69 | 515% |
| Priority Health | $50 - $69 | 515% |
| Providence | $50 - $69 | 515% |
| Rural Carrier Health Benefit Plan | $50 - $69 | 515% |