Blood test, average blood sugar (A1c)
Facility: Stormont Vail Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $29
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.99x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 299% of the Medicare baseline (a markup of 199%). 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.
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 - $36 | 103% |
| UnitedHealthcare | $10 | 103% |
| Ambetter / Centene | $10 | 103% |
Consumer Guidance & Cost Commentary
For this blood sugar test (A1c) at Stormont Vail Hospital in Topeka, KS, the facility's negotiated rates with major insurers like Blue Cross Blue Shield and UnitedHealthcare range from $10 to $36, which is significantly higher than the state average of $9.71. While commercial insurance contracts often include administrative overhead that inflates these rates, patients with high-deductible plans may find paying the cash price directly more cost-effective, as the cash rate is not explicitly listed but is generally lower than the insurer's allowed amount. It is important to note that while the facility is an in-network Acute Care Hospital, specific ancillary services or out-of-network providers involved in the test could theoretically trigger balance billing, though the No Surprises Act protects patients from such surprise charges for emergency and non-emergency services at in-network facilities.
To ensure you receive the most accurate pricing, always request a full itemized bill before paying, as summary invoices can obscure individual charges or unbundled codes that should be consolidated. If you choose to pay out-of-pocket, ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if settled upfront. Additionally, since over 80% of hospital bills contain errors, do not accept a verbal dispute resolution; instead, send a formal written audit request to the billing supervisor to verify that all services rendered match the charges listed.