CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: St Mary Medical Center

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $17
  • Cash Discount Price: $385
  • vs. Medicare Baseline: 1.75x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at St Mary Medical Center is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $385. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 1.75x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$385

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $385 (3965%)
Insurance Median: $17 (175%)
Cash: $385 (3965% of Medicare)
Ins. Median: $17 (175% 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.

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
Medicaid / KanCare $8 - $17 82%
Aetna $10 - $115 103%
Align Senior Care $10 103%
Blue Cross Blue Shield $10 - $130 103%
Cigna $10 - $52 103%
Medicare (plans) $10 - $17 103%
Health America Advantra $12 124%
UnitedHealthcare $12 - $62 124%
Pace-Trinity Health $13 134%
Ambetter / Centene $17 175%
Keystone First $17 175%
Keystone First Chip $17 175%
Oscar $17 175%
Prime Healthcare $17 175%
Jefferson Health Plan Commercial $18 185%
Homestead Health Plans Woods Center $19 196%
Group Pension Administrators $22 227%
Reedman Toll $22 227%
Blue Shield - Pa (Highmark) $26 268%
Amerihealth $50 515%
Blue Shield - Ca $50 515%
Blue Shield - Id (Regence) $50 515%
Blue Shield - Ny Highmark Western $50 515%
Blue Shield - Wa (Regence) $50 515%
Upmc Health Plan $52 536%
Webtpa $52 536%
Geha $53 546%
Meritain $115 1184%
Multiplan $116 1195%
Prime Health Services $116 1195%
Galaxy Health Network $123 1267%
Three Rivers Provider Network $123 1267%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals