CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Oakleaf Surgical Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $10
  • Cash Discount Price: $73
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Oakleaf Surgical Hospital is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 1.03x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$73

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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: $73 (752%)
Insurance Median: $10 (103%)
Cash: $73 (752% of Medicare)
Ins. Median: $10 (103% 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.

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%
Dean Health Plan $10 103%
Group Health Cooperative Of Eau Claire $10 103%
Healthpartners $10 103%
Humana $10 103%
Medica $10 103%
Quartz Health Solutions $10 103%
Security Health Plan Of Wi $10 103%
Ucare Wi $10 103%
UnitedHealthcare $10 103%

Consumer Guidance & Cost Commentary

Oakleaf Surgical Hospital in Altoona, Wisconsin, reports a cash median price of $73 for the CPT code 83036, which covers a blood test for average blood sugar (A1c). This facility is an Acute Care Hospital with physician ownership, and the data indicates that the cash rate is significantly lower than the facility's gross charge of $82. While the hospital does not have a publicly listed rating, the price transparency data shows that the median negotiated rate paid by insurers is $10, and the median paid amount is $66, which is notably lower than the cash price. This pricing structure suggests that for patients with high-deductible plans or those without insurance, paying the cash price of $73 may be more cost-effective than relying on insurance, as the negotiated rates can sometimes exceed the cash rate depending on the specific payer contract.

The facility has contracted with 10 payers, including Blue Cross Blue Shield, Humana, and UnitedHealthcare, all of which have a high and low allowed amount of $10 for this service. The Medicare benchmarking amount for this procedure is $9.71, which serves as a baseline for evaluating the facility's pricing markup. For consumers, it is important to note that balance billing could occur if a patient receives care from an out-of-network provider, though the No Surprises Act provides federal protections for emergency and non-emergency services at in-network facilities. Patients should always request an itemized billing audit to ensure no unbundled codes or services not rendered are included in the final invoice, as over 80% of hospital bills contain errors. Additionally, asking the hospital about self-pay or prompt-pay discounts before

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals