CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Pottstown Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $38
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 3.91x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Pottstown Hospital is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 3.91x the Medicare baseline. Located in 1600 East High Street, Pottstown, PA.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $44 (453%)
Insurance Median: $38 (391%)
Cash: $44 (453% of Medicare)
Ins. Median: $38 (391% 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 391% of the Medicare baseline (a markup of 291%). 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
Geisinger $8 82%
Health Partners $9 93%
Pa Health And Wellness $9 93%
Cigna $10 103%
Gateway $10 103%
Upmc $10 - $130 103%
Aetna $12 - $29 124%
UnitedHealthcare $12 124%
Blue Cross Blue Shield $47 - $61 484%
Keystone First $62 639%
First Health $157 1617%
Devon $171 1761%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 East High Street, Pottstown, PA 19464
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals