CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: North Austin Medical Center

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $38
  • Cash Discount Price: $421
  • vs. Medicare Baseline: 3.91x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at North Austin Medical Center is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $421. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 3.91x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$421

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $421 (4336%)
Insurance Median: $38 (391%)
Cash: $421 (4336% of Medicare)
Ins. Median: $38 (391% 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 391% of the Medicare baseline (a markup of 291%). 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
Superior Health Plan $7 - $119 72%
St David’S Hospice $8 - $10 82%
United $8 - $314 82%
Blue Cross Blue Shield $9 - $206 93%
Molina Healthcare $9 - $11 93%
Wellmed $9 93%
Aetna $10 103%
American Health Plan Of Texas $10 103%
Cigna $10 - $27 103%
Devoted Health $10 103%
Humana $10 103%
Odyssey Hospice $10 103%
Provider Partners Health Plan $10 103%
Pyramid Life $10 103%
Sendero $10 - $17 103%
Shared Health $10 103%
Texas Independent Health Plan $10 103%
Triwest Healthcare Alliance $10 103%
UnitedHealthcare $10 - $314 103%
Wellcare $10 103%
Imperial Insurance $11 113%
Triwest Health Alliance $11 113%
Austin Fc $12 124%
Universal Health $12 124%
Amerigroup $13 134%
Naphcare $15 154%
Seven Corners $15 154%
Corvel Corporation $19 196%
Oscar $27 - $30 278%
Moda $34 - $164 350%
Covenant Management Systems $41 - $201 422%
Healthcare Highways $42 - $209 433%
Imo Med - Select Network $43 - $209 443%
Nomi Health $46 - $258 474%
Moda Health $52 - $258 536%
Evry Health $53 - $257 546%
Texas Healthcare Foundation Heb $53 - $258 546%
Texas Workforce Commission $56 - $272 577%
Harbor Health Team $58 - $279 597%
Averde Health $65 - $314 669%
Comanche County $72 - $349 742%
National Choicecare $72 - $349 742%
Healthsmart Preferred Care $79 - $558 814%
Independent Medical Systems $79 - $384 814%
Physicians Cooperative Of Texas $79 - $384 814%
Prime Health $86 - $419 886%
First Health $90 - $496 927%
Coastal Comp Health Networks $94 - $454 968%
National Health Care $94 - $454 968%
Texas Municipal League $101 - $489 1040%
Medcorp Southwest $108 - $524 1112%
Rockport Healthcare Group $115 - $628 1184%
Bce Emergis Corporation $130 - $628 1339%
Beech Street $130 - $628 1339%
Medical Control Network Solutions $130 - $628 1339%
Multiplan $130 - $628 1339%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals