CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: UPMC Presbyterian Shadyside

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $174
Cash Discount Price: $416
vs. Medicare Baseline: 17.92x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at UPMC Presbyterian Shadyside is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $416. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 17.92x the Medicare baseline. Located in 200 Lothrop Street, Pittsburgh, PA.

Cash / Self-Pay

$416

Average discount available for prompt cash payment at this facility.

Insurance Median

$174

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: $416 (4284%)

Insurance Median: $174 (1792%)

Cash: $416 (4284% of Medicare)

Ins. Median: $174 (1792% 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 1792% of the Medicare baseline (a markup of 1692%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Health Partners Plans (Jefferson Health Plan)	$7	72%
UnitedHealthcare	$8 - $10	82%
Upmc Health Plan	$8 - $20	82%
Aetna	$9 - $174	93%
Amerihealth Caritas	$10 - $11	103%
Cigna	$10	103%
Highmark Wholecare (Prev Gateway)	$10 - $347	103%
Pa Health & Wellness	$10 - $12	103%
Upmc Work Partners	$10	103%
Geisinger	$11	113%
Multiplan	$11 - $555	113%
Blue Cross Blue Shield	$21 - $93	216%
Preferred Healthcare System	$451	4645%
Coventry/First Health	$486	5005%
Fidelis	$520	5355%
Intergroup	$520 - $590	5355%
Health Coalition Partners	$555	5716%
Private Health Care Systems	$555	5716%
Selectcare	$555	5716%
Health Payors Organization	$590	6076%
Humana	$590	6076%

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 $416.
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 UPMC Presbyterian Shadyside 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.