CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Othello Community Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $143
Cash Discount Price: $134
vs. Medicare Baseline: 14.73x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Othello Community Hospital is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 14.73x the Medicare baseline. Located in 315 North 14Th Avenue, Othello, WA.

Cash / Self-Pay

$134

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $134 (1380%)

Insurance Median: $143 (1473%)

Cash: $134 (1380% of Medicare)

Ins. Median: $143 (1473% 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 1473% of the Medicare baseline (a markup of 1373%). 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
Ambetter / Centene	$76 - $77	783%
Amerigroup Mcaid	$76	783%
Chp Mcaid	$76	783%
Cocare - All Plans	$76	783%
Gau - All Plans	$76	783%
Kaiser - All Plans	$76	783%
Molina Mcaid	$76	783%
UnitedHealthcare	$76 - $179	783%
Chp - All Other Plans	$77	793%
Molina - All Other Plans	$77	793%
Medicare (plans)	$90	927%
Tricare	$116	1195%
Triwest - All Plans	$116	1195%
Asuris - All Plans	$143	1473%
Commercial Other - All Plans	$143	1473%
Hma - All Plans	$143	1473%
Hmso - All Plans	$143	1473%
Tpsc - All Plans	$143	1473%
Travelers - All Plans	$143	1473%
Veterans Admin - All Plans	$143	1473%
Blue Cross Blue Shield	$150	1545%
Cigna	$159	1637%
First Choice - All Plans	$161	1658%
Aetna	$168	1730%
Chp Mcr Adv	$179	1843%
Health Alliance Mcr Adv - All Plans	$179	1843%
Humana	$179	1843%
Molina Mcare	$179	1843%
Wellcare Mcr Adv - All Plans	$179	1843%

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 $134.
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 Othello Community 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.