CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Margaretville Memorial Hospital

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $65
Cash Discount Price: $147
vs. Medicare Baseline: 6.69x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Margaretville Memorial Hospital is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $147. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 6.69x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$147

Average discount available for prompt cash payment at this facility.

Insurance Median

$65

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: $147 (1514%)

Insurance Median: $65 (669%)

Cash: $147 (1514% of Medicare)

Ins. Median: $65 (669% 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 669% of the Medicare baseline (a markup of 569%). 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	$15 - $65	154%
Oxford	$15	154%
Aetna	$26 - $147	268%
Mvp	$41	422%
Mvp Hmo/Ppo	$49	505%
Blue Cross Blue Shield	$57 - $76	587%
Hamaspik (McR)	$65	669%
Mvp Gold (McR)	$65	669%
Medicare (plans)	$65 - $97	669%
Affinity By Molina McR	$68	700%
Cdphp	$71	731%
Self-Pay	$82	844%
Emblem Ghi/Hip Ppo/Cbp	$91	937%
Mvp Exchange	$96	989%
Emblem Select Care (Exchange)	$100	1030%
Oxford Exchange	$103	1061%
Magnacare Standard	$103	1061%
Todays Options	$107	1102%
Emblem Ghi/Hip Hmo/Epo/Pos	$118	1215%
Multiplan	$121	1246%
First Health	$132	1359%
Magnacare Preferred	$581	5984%

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 $147.
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 Margaretville Memorial 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.