CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Texas Childrens Hospital North Austin Campus

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $89
Cash Discount Price: $96
vs. Medicare Baseline: 9.17x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Texas Childrens Hospital North Austin Campus is $89. 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 9.17x the Medicare baseline. Located in 9835 North Lake Creek Parkway Bldg A, Austin, TX.

Cash / Self-Pay

$96

Average discount available for prompt cash payment at this facility.

Insurance Median

$89

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: $89 (917%)

Cash: $96 (989% of Medicare)

Ins. Median: $89 (917% 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 917% of the Medicare baseline (a markup of 817%). 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
Superior Chip	$10	103%
Driscoll Children'S Health Plan Mcd	$11	113%
Community Health Choice	$17 - $95	175%
First Care Health Plan	$38 - $95	391%
UnitedHealthcare	$38 - $95	391%
Molina Mcd	$42 - $44	433%
Blue Cross Blue Shield	$49 - $93	505%
Community First Health Plan Mcd	$56 - $59	577%
Cook Children'S Health Plan	$56 - $59	577%
Cigna	$79 - $95	814%
Aetna	$89 - $95	917%
Kelseycare	$90 - $96	927%
Healthsmart	$97 - $104	999%
Evolutions Healthcare	$104 - $111	1071%
First Health	$122 - $141	1256%
Multiplan	$125 - $133	1287%
Galaxy Health Network	$132 - $141	1359%

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 $96.
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 Texas Childrens Hospital North Austin Campus 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.