CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Mercy St Francis Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $113
Cash Discount Price: $82
vs. Medicare Baseline: 11.64x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Mercy St Francis Hospital is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 11.64x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.

Cash / Self-Pay

$82

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $82 (844%)

Insurance Median: $113 (1164%)

Cash: $82 (844% of Medicare)

Ins. Median: $113 (1164% 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 1164% of the Medicare baseline (a markup of 1064%). 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
UnitedHealthcare	$10 - $120	103%
Blue Cross Blue Shield	$10 - $122	103%
Medicare (plans)	$10 - $45	103%
Medicaid / KanCare	$10 - $65	103%
Aetna	$10 - $112	103%
Indian Health Service Contracted [320198]	$35 - $43	360%
Acentra Health Contracted [320527]	$35	360%
Qual Choice Contracted [320325]	$35 - $43	360%
Humana	$35 - $113	360%
Provider Partners Health Plans Contracted [320450]	$35 - $43	360%
Globalhealth Contracted [320145]	$35 - $43	360%
Pace of the Ozarks Contracted [320518]	$35 - $43	360%
Halo Hcr Inc Hospice Contracted [320432]	$35 - $43	360%
Elara Caring Aspire Hospice [20433]	$35 - $43	360%
Cross Timbers Hospice [20098]	$35 - $43	360%
Halo Hcr Inc Hospice [20432]	$35 - $43	360%
Dept of Veteran Affairs Contracted [320106]	$35 - $43	360%
Mercy Hospice Okc [20252]	$35 - $43	360%
Kindful Hospice Contracted [320434]	$35 - $43	360%
Kindful Hospice [20434]	$35 - $43	360%
Medical Associates Health Contracted [320444]	$35 - $43	360%
Cigna	$35 - $120	360%
Cherokee Nation Health Serv Contracted [320066]	$35 - $43	360%
Mercy Mgd Behavioral Health Contracted [320259]	$35 - $43	360%
Tricare	$43	443%
Healthscope Contracted [320182]	$43 - $57	443%
Centivo Contracted [320505]	$57 - $73	587%
Administrative Payor Contracted [320005]	$57	587%
Ambetter / Centene	$65	669%
Home State Health Plan Contracted [320187]	$65	669%
Novasys Contracted [320285]	$65	669%
Preferred Health Plan Contracted [320522]	$82	844%
Healthlink Contracted [320179]	$82 - $120	844%
Workers Comp [20426]	$101 - $107	1040%
Point C Contracted [320238]	$113 - $120	1164%
Auxiant Contracted [320462]	$113 - $120	1164%
Mercy Benefit Admin Contracted [320251]	$113 - $120	1164%
United Medical Resources Contracted [320454]	$113 - $117	1164%
Medica Contracted [320239]	$119	1226%
Show-Me Health Administrators Contracted [320483]	$120	1236%
90 Degree Benefits Contracted [320436]	$120	1236%
Evolutions Health Care Contracted [320124]	$120	1236%
Benefit Management Contracted [320052]	$120	1236%
Insurance System Inc Contracted [320465]	$120	1236%
Ebms Contracted [320493]	$120	1236%
Edison Health Solutions Contracted [320502]	$120	1236%
Yuzu Health Contracted [320521]	$120	1236%
Health Systems Inc Contracted [320174]	$120	1236%
Multiplan Contracted [320270]	$120	1236%
Point C [20238]	$120	1236%
First Health Contracted [320128]	$120	1236%
Aither Health Contracted [320449]	$120	1236%
USA Managed Care Org Contracted [320429]	$120	1236%
Private Health Care Systems Contracted [320320]	$120	1236%
Reflect Health Contracted [320492]	$120	1236%
Imagine 360 Contracted [320494]	$120	1236%

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 $82.
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 Mercy St Francis 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.