Blood test, average blood sugar (A1c)
Facility: Lmh
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $10
- Cash Discount Price: $21
- vs. Medicare Baseline: 1.03x 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.
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 |
|---|---|---|
| Cigna | $5 - $156 | 51% |
| Blue Cross Blue Shield | $6 - $101 | 62% |
| Non Contracted | $7 - $125 | 72% |
| Aetna | $7 - $129 | 72% |
| UnitedHealthcare | $8 - $158 | 82% |
| First Health | $8 - $145 | 82% |
| Haskell Indian Health Services | $8 - $10 | 82% |
| Humana | $8 - $156 | 82% |
| Medicare (plans) | $8 - $156 | 82% |
| Ambetter / Centene | $8 - $15 | 82% |
| Allwell | $9 - $10 | 93% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Lmh in Lawrence, KS, the cash median price is $21.00, which is significantly lower than the facility's gross charge of $82.00. While the facility is in-network for most major payers, the negotiated rates vary widely, ranging from a low of $5 to a high of $156 depending on the insurance plan. Because commercial insurance negotiated rates often include administrative overhead and can exceed the cash price, patients with high-deductible plans may find it financially advantageous to pay the cash median directly. To maximize savings, it is recommended to contact the hospital before scheduling to confirm "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by offering immediate liquidity incentives.
This facility's pricing is evaluated against a Medicare benchmark of $9.71, indicating that the cash rate represents a markup of 216% over the federal baseline. Although the facility is government-owned and holds a 4-star rating, the wide variance in negotiated rates across the 11 payer plans suggests that individual plan benefits heavily influence out-of-pocket costs. Patients should avoid accepting summary bills and instead request a detailed, itemized statement to verify that all charges align with the negotiated or cash rates. If a balance bill arises from out-of-network ancillary services, consumers have the right to dispute the amount under federal protections, ensuring they are not billed for the difference between the provider's full charge and the insurance allowed amount.