Blood test, average blood sugar (A1c)
Facility: Centura St. Catherine-Dodge City
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $179
- Cash Discount Price: $109
- vs. Medicare Baseline: 18.43x 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 1843% of the Medicare baseline (a markup of 1743%). 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 |
|---|---|---|
| Kansas Health | $10 | 103% |
| Aetna | $10 - $217 | 103% |
| Medicare (plans) | $10 | 103% |
| Blue Cross Blue Shield | $10 - $42 | 103% |
| Humana | $10 | 103% |
| Kaiser | $10 | 103% |
| Cigna | $10 | 103% |
| Centura Employee Plan | $12 | 124% |
| UnitedHealthcare | $179 | 1843% |
| Wpaa | $190 | 1957% |
| Christian Health Aid | $217 | 2235% |
| Multiplan | $217 - $244 | 2235% |
| Health Partners Of Kansas | $244 | 2513% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Centura St. Catherine-Dodge City, the facility's cash median price of $109 is significantly lower than the state average for this service. While the facility's negotiated rates with major payers like UnitedHealthcare and Wpaa are set at $179 and $190 respectively, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that while the facility is in-network for many insurers, the No Surprises Act generally protects patients from balance billing for out-of-network services at in-network facilities, though patients should still verify their specific plan details and ask the hospital about any "self-pay" or "prompt-pay" discounts available before scheduling.
The facility's Medicare benchmark rate of $9.71 serves as a critical baseline for evaluating pricing fairness, as commercial negotiated rates typically range from 200% to 300% of this amount, whereas fair pricing is often defined as 120% to 150%. Although the facility's negotiated rates appear reasonable compared to the gross charges, patients should avoid accepting summary bills and instead request a detailed, itemized audit to ensure no errors, double-billing, or unbundled codes are present. Since over 80% of hospital bills contain errors, obtaining a line-by-line statement is the most effective way to identify charges for services not rendered or supplies that were cancelled, ensuring the final invoice accurately reflects the care received.