Blood test, average blood sugar (A1c)
Facility: Wesley Medical Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $21
- Cash Discount Price: $385
- vs. Medicare Baseline: 2.16x 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 216% of the Medicare baseline (a markup of 116%). 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 |
|---|---|---|
| Aetna | $10 - $137 | 103% |
| Ambetter / Centene | $10 - $69 | 103% |
| Humana | $10 | 103% |
| Medicaid / KanCare | $10 | 103% |
| Triwest Health Alliance | $10 | 103% |
| Coventry Health Care | $10 | 103% |
| Amerigroup | $10 | 103% |
| Devoted Health | $10 | 103% |
| UnitedHealthcare | $10 | 103% |
| United | $10 - $173 | 103% |
| Correct Care Solutions | $15 | 154% |
| First Health | $20 - $177 | 206% |
| Multiplan | $21 - $346 | 216% |
| Blue Cross Blue Shield | $27 | 278% |
| Wppa | $67 | 690% |
| Health Partners Of Kansas | $67 - $192 | 690% |
| Preferred Health Choices | $73 | 752% |
| Medical Associates Health Plan | $73 | 752% |
| Spirit Aerosystems | $123 | 1267% |
| Triwest Healthcare Alliance | $250 | 2575% |
| Usa Managed Care | $327 | 3368% |
Consumer Guidance & Cost Commentary
For this blood sugar test (CPT 83036) at Wesley Medical Center in Wichita, KS, the cash price is $385.00, which matches the facility's cash median. This rate is significantly higher than the Medicare benchmark of $9.71, reflecting a markup of 2.2 times the federal standard. While the facility's negotiated rates for commercial payers range from $10 to $327, these amounts are generally lower than the cash price but may still exceed what a patient pays out-of-pocket depending on their specific plan. It is important to note that for patients with high-deductible plans, paying the cash price directly can sometimes be more cost-effective than using insurance, as the negotiated rates often include administrative overhead and do not reflect the actual cash price.
Patients should verify their specific plan details before scheduling, as some in-network carriers may negotiate rates that are higher than the cash option. Many facilities offer prompt-pay discounts, typically ranging from 20% to 50%, for patients who pay in full upfront, which can reduce the $385.00 cash price to a lower amount. Additionally, under federal protections like the No Surprises Act, patients are generally shielded from balance billing for out-of-network services at in-network facilities, though it remains crucial to request an itemized bill to ensure no errors or unbundled charges exist. Always confirm with the hospital whether "self-pay" or "prompt-pay" rates apply prior to check-in to avoid unexpected costs.