CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Houston Methodist West Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $16
Cash Discount Price: $248
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Houston Methodist West Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $248. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 1.65x the Medicare baseline. Located in 18500 Katy Freeway, Houston, TX.

Cash / Self-Pay

$248

Average discount available for prompt cash payment at this facility.

Insurance Median

$16

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: $248 (2554%)

Insurance Median: $16 (165%)

Cash: $248 (2554% of Medicare)

Ins. Median: $16 (165% 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.

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
Aetna	$10	103%
Cigna	$10 - $120	103%
Community Health Choice	$10 - $16	103%
Molina Healthcare	$10 - $19	103%
UnitedHealthcare	$10 - $19	103%
Procare Advantage	$11	113%
Uae	$39	402%
Blue Cross Blue Shield	$40	412%

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 $248.
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 Houston Methodist West Hospital 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.