CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Stoughton Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83036
  • Insurance Median: $57
  • Cash Discount Price: $105
  • vs. Medicare Baseline: 5.87x Medicare
The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Stoughton Hospital is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 5.87x the Medicare baseline. Located in 900 Ridge St, Stoughton, WI.
Cash / Self-Pay
$105

Average discount available for prompt cash payment at this facility.

Insurance Median
$57

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: $105 (1081%)
Insurance Median: $57 (587%)
Cash: $105 (1081% of Medicare)
Ins. Median: $57 (587% 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 587% of the Medicare baseline (a markup of 487%). 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
Medicaid / KanCare $5 51%
Alliance - All Plans $18 185%
Tricare $45 463%
Healthnet Mcr Adv - All Plans $51 525%
Dean Health Insurance Med Adv $53 546%
Humana $53 - $171 546%
Quartz Mcr Adv $53 546%
Security Health/First Health - All Plans $53 546%
Dean Health Insurance Comm - All Other Plans $54 556%
Dean Health Insurance Epo $54 556%
Aetna $57 - $162 587%
UnitedHealthcare $84 - $152 865%
Quartz Health Solutions - All Other Lans $124 1277%
Geha - All Plans $142 1462%
Cigna $152 1565%
Wisconsin Ppo Ppa Direct - All Plans $152 1565%
Blue Cross Blue Shield $165 1699%
Wps - All Plans $171 1761%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 900 Ridge St, Stoughton, WI 53589
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals