Is it cheaper to pay cash than use insurance?

Sometimes. Several hospitals publish discounted cash prices below the rates insurers negotiate. If you haven't met your deductible, ask for the self-pay price.

Why do prices differ so much between hospitals?

Each hospital negotiates rates separately with each insurer, and hospitals in the same health system usually share one contract. The same procedure with the same insurer can cost several times more across town.

Costs · Lab · Blood sugar test (hemoglobin A1c) · San Francisco Bay Area · code 83036

How much does a blood sugar test (hemoglobin a1c) cost in San Francisco Bay Area?

Q: How much does Blood sugar test (hemoglobin A1c) cost in San Francisco Bay Area?

Median insurer-negotiated rates range from $10 at Alta Bates Summit Medical Center – Alta Bates Campus to $133 at Mills-Peninsula Medical Center, based on the hospitals' own federally mandated price files.

Blood test of average blood sugar over three months. Below: the rates insurers have actually negotiated with 26 San Francisco Bay Area-area hospitals, and the cash (self-pay) prices where published — from the hospitals' own federally required price files.

$10

lowest median negotiated rate

Alta Bates Summit Medical Center – Alta Bates Campus

$133

highest (adult hospitals)

Mills-Peninsula Medical Center

13.3×

price spread

same procedure, same metro

Rates shown

Median negotiated rate per hospital · sorted low → high · hover a bar for the full receipt

cash (self-pay) price

Hospital	Gross charge	Cash price	Negotiated	Range	# rates	vs median

* Specialty hospital (pediatric or cancer center) — rates reflect specialty case mix. † Median based on fewer than 3 published rates — treat as indicative. Bars show the median dollar-denominated commercial negotiated rate; hospitals sharing a health-system contract show similar rates.

SOURCE: standard-charges files from 26 hospitals · file dates 2026-03-01 → 2026-04-01 · retrieved 2026-08-15

Tip: if you haven't met your deductible, ask each hospital for its discounted cash price — it is often far below the billed charge.

Skipping the hospital? 53 independent imaging/outpatient centers in this area negotiate a median $8 all-in for this procedure (106 insurer rates) — less than the lowest hospital facility fee above ($10).

Ccrm San Francisco, Llc — $3
Arthur Baca — $4
Spectra Laboratories Inc — $5
Laguna Hills Pathology Lab Llc — $5

All-in (global) negotiated fees from Anthem Blue Cross, Blue Shield of California, Cigna, and UnitedHealthcare's federally mandated Transparency-in-Coverage files, newest dated 2026-08-01; hospital bars above show the facility fee only — a physician fee is usually billed on top. Estimates — confirm with the provider.

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