Blood test, average blood sugar (A1c)
Facility: Mcpherson Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $44
- Cash Discount Price: $71
- vs. Medicare Baseline: 4.53x 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 453% of the Medicare baseline (a markup of 353%). 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 |
|---|---|---|
| Tricare | $9 | 93% |
| Wellcare Mcr Adv - All Plans | $10 | 103% |
| Va Ccn - All Plans | $10 | 103% |
| Humana | $10 | 103% |
| UnitedHealthcare | $10 - $148 | 103% |
| Healthy Blue Mcr Adv | $10 | 103% |
| Blue Cross Blue Shield | $10 | 103% |
| Ambetter / Centene | $11 | 113% |
| Wppa - All Plans | $32 - $104 | 330% |
| Central Plains - All Plans | $34 - $111 | 350% |
| Medical Associates - All Plans | $34 - $111 | 350% |
| Christian Health Aid - All Plans | $36 - $118 | 371% |
| Aetna | $37 - $148 | 381% |
| Multiplan - All Plans | $40 - $133 | 412% |
| Cigna | $43 - $141 | 443% |
| First Health - All Plans | $43 - $141 | 443% |
| Health Partners - All Plans | $43 - $141 | 443% |
| Medicaid / KanCare | $45 - $148 | 463% |
| Health Blue Mcaid - All Other Plans | $46 - $151 | 474% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at McPherson Hospital in McPherson, Kansas, the cash median price is $71.00, which is lower than the facility's gross charge of $97.00. While commercial insurance plans like UnitedHealthcare and Aetna have negotiated rates ranging from $32 to $148, these amounts often exceed the cash price. Patients with high-deductible plans may find paying the cash median of $71.00 upfront more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the deductible has not been met. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling the procedure.
The facility's negotiated rates for this service average $44.00, which is slightly higher than the cash price but generally aligns with the median negotiated rate of $44.00 reported for this code. When comparing pricing benchmarks, the Medicare amount of $9.71 serves as the objective baseline for evaluating the facility's markup, with commercial rates typically ranging from 200% to 300% of this federal rate. If a patient receives care from an out-of-network provider or encounters unexpected ancillary services, they may face balance billing for the difference between the allowed amount and the full chargemaster rate. To avoid surprise costs, patients should request a detailed, itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.