CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Sanford Clear Lake Medical Center

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $65
  • Cash Discount Price: $62
  • vs. Medicare Baseline: 6.69x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Sanford Clear Lake Medical Center is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 6.69x the Medicare baseline. Located in 701 Third Avenue South, Clear Lake, SD.
Cash / Self-Pay
$62

Average discount available for prompt cash payment at this facility.

Insurance Median
$65

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: $62 (639%)
Insurance Median: $65 (669%)
Cash: $62 (639% of Medicare)
Ins. Median: $65 (669% 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 669% of the Medicare baseline (a markup of 569%). 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
Sanford Health Plan Align $40 412%
Aetna $43 - $68 443%
Health Partners $43 - $58 443%
Medicare (plans) $43 443%
Security Health Plan $43 443%
Ucare $43 - $69 443%
UnitedHealthcare $43 - $65 443%
Wellmark Sd $43 443%
Primewest $44 453%
Sanford Health Plan $54 - $73 556%
Medica $64 - $69 659%
Wellmark $67 - $68 690%
Cigna $70 721%
First Choice Health Network $70 721%
Healthez $70 721%
Multiplan $70 721%
Blue Cross Blue Shield $77 793%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 Third Avenue South, Clear Lake, SD 57226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals