CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Holy Family Memorial

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $14
Cash Discount Price: $25
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Holy Family Memorial is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 1.44x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.

Cash / Self-Pay

$25

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $25 (257%)

Insurance Median: $14 (144%)

Cash: $25 (257% of Medicare)

Ins. Median: $14 (144% 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
Medical College Of Wisconsin	$6 - $24	62%
Centivo	$7 - $34	72%
Dean Health Plan	$9 - $37	93%
Allwell	$10	103%
Blue Cross Blue Shield	$10 - $13	103%
Community Care Incorporated	$10	103%
Health Partners	$10 - $48	103%
Humana	$10	103%
Icare	$10	103%
Molina	$10	103%
Network Health Plan	$10 - $41	103%
Security Health Plan	$10 - $59	103%
UnitedHealthcare	$10 - $12	103%
Sheboygan Employers Health Network	$11 - $44	113%
Trilogy	$12 - $49	124%
Cigna	$13 - $53	134%
Wps Health Plan	$13 - $55	134%
Aspirus	$14 - $59	144%
Healtheos	$14 - $59	144%
Multiplan/Private Healthcare Systems	$14 - $59	144%
Preferred One	$14 - $59	144%
Healthsmart	$15 - $61	154%
First Health Network	$16 - $65	165%
Health Payment Systems	$24	247%
Chorus Community Health Plan	$28	288%

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 $25.
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 Holy Family Memorial 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.