CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Tristar Southern Hills Medical Center

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $55
  • Cash Discount Price: $320
  • vs. Medicare Baseline: 5.66x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Tristar Southern Hills Medical Center is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $320. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 5.66x the Medicare baseline. Located in 391 Wallace Rd, Nashville, TN.
Cash / Self-Pay
$320

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $320 (3296%)
Insurance Median: $55 (566%)
Cash: $320 (3296% of Medicare)
Ins. Median: $55 (566% 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 566% of the Medicare baseline (a markup of 466%). 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
Wellpoint $4 41%
Aetna $8 - $170 82%
Ambetter / Centene $10 103%
American Health Advantage $10 103%
Amerigroup $10 103%
Blue Cross Blue Shield $10 - $54 103%
Bright Health $10 - $11 103%
Devoted Health Plan $10 103%
Evergreen Hmo $10 103%
Healthspring $10 103%
Humana $10 - $85 103%
Odyssey Healthcare $10 103%
Sarah Cannon Research $10 103%
Signature Advantage $10 103%
United $10 - $153 103%
Wellcare $10 103%
Zing $10 103%
Atrio Golden Times $11 113%
Corvel Corporation $14 144%
Novanet $14 144%
Prime Health $14 - $300 144%
Cigna $17 - $111 175%
Oscar $29 299%
Kentucky Labor Cabinet $55 - $63 566%
Apex Health $57 - $65 587%
Nhc Advantage, Inc. $57 - $65 587%
Pruitt Health (Allyalign) $57 - $65 587%
Centurion $123 - $140 1267%
Bgfh Singlesource $149 - $290 1535%
Multiplan $173 - $198 1782%
Employers Health Network $209 - $239 2152%
Odom'S Tn Pride Sausage $224 - $256 2307%
Beech Street $263 - $300 2709%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 391 Wallace Rd, Nashville, TN 37211
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals