CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $144
  • Cash Discount Price: $78
  • vs. Medicare Baseline: 14.83x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Carilion Stonewall Jackson Hospital is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 14.83x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.
Cash / Self-Pay
$78

Average discount available for prompt cash payment at this facility.

Insurance Median
$144

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: $78 (803%)
Insurance Median: $144 (1483%)
Cash: $78 (803% of Medicare)
Ins. Median: $144 (1483% 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 1483% of the Medicare baseline (a markup of 1383%). 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
Blue Cross Blue Shield $10 103%
Sentara Health Plan $10 - $139 103%
Abh of VA (Formerly Coventry) $11 113%
Abh of Wva (Formerly Coventry) $11 113%
Humana $11 113%
UnitedHealthcare $11 - $183 113%
Aetna $114 - $149 1174%
Gateway - Tier 3 $123 1267%
Vhn - Ultra $139 1432%
Connecticare $157 1617%
Cigna $179 1843%
Gateway - Tier 2 $179 1843%
Vhn - Plus $179 1843%
Integrated Health Plan $190 1957%
Vhn $190 1957%
Vhn - Link $202 2080%
Beech Street $206 2122%
Gateway - Tier 1 $213 2194%
Vhn - Secondary Payors $213 2194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Health Circle, Lexington, VA 24450
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals