CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Pennsylvania Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $90
  • Cash Discount Price: $262
  • vs. Medicare Baseline: 9.27x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Pennsylvania Hospital is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $262. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 9.27x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$262

Average discount available for prompt cash payment at this facility.

Insurance Median
$90

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: $262 (2698%)
Insurance Median: $90 (927%)
Cash: $262 (2698% of Medicare)
Ins. Median: $90 (927% 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 927% of the Medicare baseline (a markup of 827%). 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
Cigna $6 - $89 62%
Gateway Health Plan $7 - $12 72%
Medicaid / KanCare $7 - $262 72%
Pa Medical Assistance $7 72%
Keystone Mercy Health Plan $9 93%
Aetna $10 - $262 103%
Blue Cross Blue Shield $10 - $262 103%
Clover Health Plan $10 103%
Geisinger Health Plan $10 - $31 103%
Health Partners $10 - $262 103%
Humana $10 - $210 103%
Ibc $10 103%
Medicare (plans) $10 103%
Pa Health And Wellness $10 - $16 103%
Penn Life (Living Independently For Elders) $10 103%
Philadelphia Va Medical Center $10 103%
UnitedHealthcare $10 - $262 103%
Upmc $10 - $262 103%
Keystone First $11 113%
Tricare $11 113%
Us Family Health Plan $11 113%
Elap $14 144%
Claims Watcher $16 - $17 165%
Centivo $17 175%
Ibc Commercial Hpn $17 175%
Keystone Hmo Proactive $17 175%
Oscar Health Plan $17 175%
Elap Services $18 185%
Highmark $20 206%
Penn Global Medicine $26 268%
Horizon Nj Health $44 - $46 453%
Pgm - Regie De L'Assurance Maladie Quebec $60 618%
Preferred Health Care Eliance $68 700%
Pgm - Kuwait Defense $92 - $118 947%
Devon $100 - $118 1030%
Qualcare $100 1030%
Coventry $105 - $134 1081%
Pgm - Chop $105 1081%
Wissahickon Hospice $105 1081%
Healthamerica/Coventry $118 - $128 1215%
Olympus $127 1308%
First Health Global $131 1349%
Urn-Cancer Resource Services $131 1349%
Health Net $157 1617%
Pgm - Royal Embassy Of Saudi Arabia $157 1617%
Pgm - Embassy Of Qatar $170 1751%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $170 1751%
Pgm - Embassy Of The United Emirates/Ipc $183 1885%
Devon Health Services Inc $210 2163%
Health America/Ccn $210 2163%
Intergroup $210 2163%
Pgm - Kuwait Health Division $210 2163%
Pgm - Kuwait Oil $210 2163%
Preferred Care $210 2163%
Commercial Other $262 2698%
Community Behavioral Health $262 2698%
International Pfs $262 2698%
Quest Behavioral Health $262 2698%
United Behavioral Health $262 2698%
Workers Compensation $262 2698%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals