CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Children's Hospital of Philadelphia

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $86
Cash Discount Price: $224
vs. Medicare Baseline: 8.86x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Children's Hospital of Philadelphia is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 8.86x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$224

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $224 (2307%)

Insurance Median: $86 (886%)

Cash: $224 (2307% of Medicare)

Ins. Median: $86 (886% 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 886% of the Medicare baseline (a markup of 786%). 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
Geisinger Medical Assistance	$9	93%
Highmark Wholecare	$10	103%
Horizon Nj Health	$24	247%
Medicaid / KanCare	$28 - $46	288%
UnitedHealthcare	$29 - $152	299%
Health Partners	$32 - $52	330%
Aetna	$41 - $139	422%
Upmc Medical Assistance	$47 - $76	484%
Keystone First Chip	$53 - $86	546%
Keystone Health Plan East	$54 - $88	556%
Blue Cross Blue Shield	$61 - $111	628%
Geisinger Health Plan Commercial	$76 - $122	783%
Jefferson Health Plans	$81 - $131	834%
Cigna	$86 - $139	886%
Highmark	$86 - $139	886%
Qualcare	$95 - $152	978%
First Health Network	$112 - $180	1153%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$137 - $222	1411%
Private Health Care Systems	$137 - $222	1411%
Choice Care Network	$155 - $249	1596%

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 $224.
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 Children's Hospital of Philadelphia 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.