CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Prisma Health Oconee Memorial Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $13
  • Cash Discount Price: $96
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Prisma Health Oconee Memorial Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 1.34x the Medicare baseline. Located in 298 Memorial Dr, Seneca, SC.
Cash / Self-Pay
$96

Average discount available for prompt cash payment at this facility.

Insurance Median
$13

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: $96 (989%)
Insurance Median: $13 (134%)
Cash: $96 (989% of Medicare)
Ins. Median: $13 (134% 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
Cigna $8 - $55 82%
Evernorth Behavioral Contracted [2982] $8 - $55 82%
Mvp Health Care [3037] $8 - $55 82%
Tricare $8 82%
Golden Rule Insurance Company [2991] $9 93%
Oxford Health Plans [2992] $9 93%
UnitedHealthcare $9 - $12 93%
Zzumr-Salt Lake City Ut [3169] $9 93%
Aetna $10 - $116 103%
Blue Cross Blue Shield $10 - $65 103%
Champva [3049] $10 103%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $10 103%
Deseret Mutual Ins Co [3066] $10 103%
Generic Skilled Nursing [3196] $10 103%
Healthy Conn Prime-First Choice Vip Care [5300] $10 103%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $10 103%
Hospice Contracted [1500] $10 103%
Hospice Non Contracted [3190] $10 103%
Humana $10 - $13 103%
Medicare (plans) $10 - $13 103%
Triwest Healthcare Alliance Vcp [902] $10 103%
Va Community Care Network-Vaccn [903] $10 103%
Veterans Administration [3194] $10 103%
Healthy Conn Prime-Molina Healthcare [5330] $11 113%
Medicaid / KanCare $12 - $13 124%
First Choice Benefits Mgmt [3074] $13 134%
Workers Comp [600] $14 144%
Medcost [2940] $16 - $122 165%
Preferred Administrators Contracted [2839] $17 - $103 175%
Ambetter / Centene $18 185%
Bluechoice [810] $18 - $87 185%
Multiplan/Phcs Contracted [2950] $18 - $131 185%
Atlantic Packaging Contracted [4833] $19 - $110 196%
Promise Health Plan Contracted [2401] $21 - $88 216%
Meritain Health Contracted [2200] $26 - $116 268%
Prisma Health Seniorcare Pace - Midlands [5400] $34 350%
Prisma Health Seniorcare Pace-Upstate [5200] $34 350%
Sc Dept Of Corrections [2998] $37 381%
Scdc-Sc Dept Of Corrections [7232] $37 381%
Orangeburg Senior Helping Center Pace [5401] $59 608%
Planned Administrators [820] $65 669%
Bob Jones Univ-Pai [821] $88 906%
Aps Healthcare System [2981] $118 1215%
Vsp Vision Care [2986] $132 1359%
First Health Contracted [2952] $137 1411%
Furman Int/Allen University Student [2951] $137 1411%
Quiktrip-First Health [3067] $137 1411%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 298 Memorial Dr, Seneca, SC 29672
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals