CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Penn Presbyterian Medical Center

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $34
  • Cash Discount Price: $181
  • vs. Medicare Baseline: 3.50x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Penn Presbyterian Medical Center is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $181. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 3.50x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$181

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $181 (1864%)
Insurance Median: $34 (350%)
Cash: $181 (1864% of Medicare)
Ins. Median: $34 (350% 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 350% of the Medicare baseline (a markup of 250%). 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
UnitedHealthcare $5 - $320 51%
Cigna $6 - $101 62%
Horizon Nj Health $7 - $56 72%
Medicaid / KanCare $7 - $320 72%
Pa Medical Assistance $7 72%
Keystone Mercy Health Plan $9 - $320 93%
Aetna $10 - $320 103%
Blue Cross Blue Shield $10 - $320 103%
Clover Health Plan $10 103%
Geisinger Health Plan $10 - $31 103%
Health Partners $10 - $320 103%
Humana $10 - $256 103%
Ibc $10 103%
Medicare (plans) $10 103%
Pa Health And Wellness $10 - $16 103%
Penn Life (Living Independently For Elders) $10 103%
Pgm - Regie De L'Assurance Maladie Quebec $10 - $74 103%
Philadelphia Va Medical Center $10 103%
Preferred Health Care Eliance $10 - $80 103%
Upmc $10 - $320 103%
Keystone First $11 113%
Tricare $11 113%
Us Family Health Plan $11 113%
Gateway Health Plan $12 124%
Elap $14 144%
Pgm - Kuwait Defense $15 - $144 154%
Claims Watcher $16 - $17 165%
Devon $16 - $144 165%
Qualcare $16 - $122 165%
Centivo $17 175%
Coventry $17 - $163 175%
Ibc Commercial Hpn $17 175%
Keystone Hmo Proactive $17 175%
Oscar Health Plan $17 175%
Pgm - Chop $17 - $128 175%
Wissahickon Hospice $17 - $128 175%
Elap Services $18 185%
Healthamerica/Coventry $19 - $157 196%
Highmark $20 206%
Olympus $20 - $152 206%
First Health Global $21 - $160 216%
Urn-Cancer Resource Services $21 - $160 216%
Health Net $25 - $192 257%
Pgm - Royal Embassy Of Saudi Arabia $25 - $192 257%
Penn Global Medicine $26 268%
Pgm - Embassy Of Qatar $27 - $208 278%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $27 - $208 278%
Pgm - Embassy Of The United Emirates/Ipc $29 - $224 299%
Devon Health Services Inc $34 - $256 350%
Health America/Ccn $34 - $256 350%
Intergroup $34 - $256 350%
Pgm - Kuwait Health Division $34 - $256 350%
Pgm - Kuwait Oil $34 - $256 350%
Preferred Care $34 - $256 350%
Commercial Other $42 - $320 433%
International Pfs $42 - $320 433%
Magellan $42 - $320 433%
Quest Behavioral Health $42 - $320 433%
United Behavioral Health $42 - $320 433%
Workers Compensation $42 - $320 433%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals