Blood test, average blood sugar (A1c)
Facility: Overland Park Reg Med Ctr
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $48
- Cash Discount Price: $273
- vs. Medicare Baseline: 4.94x 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 494% of the Medicare baseline (a markup of 394%). 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 |
|---|---|---|
| Cigna | $5 - $10 | 51% |
| Aetna | $9 - $146 | 93% |
| Home State Health Plan | $9 | 93% |
| United | $9 - $128 | 93% |
| Coventry | $10 - $115 | 103% |
| Pyramid Life | $10 | 103% |
| Unicare | $10 | 103% |
| Celtic | $10 | 103% |
| Humana | $10 - $24 | 103% |
| Blue Cross Blue Shield | $10 - $123 | 103% |
| Triwest Health Alliance | $10 | 103% |
| Wellcare | $10 | 103% |
| Medicaid / KanCare | $10 | 103% |
| Devoted Health | $10 | 103% |
| Amerigroup | $10 | 103% |
| Healthyblue | $10 | 103% |
| Oscar | $15 | 154% |
| Multiplan | $17 - $211 | 175% |
| Corvel Corporation | $20 - $186 | 206% |
| Oha Network | $21 - $143 | 216% |
| Ambetter / Centene | $48 - $53 | 494% |
| Nhc Advantage | $49 - $54 | 505% |
| Wppa Providrs Care Network | $52 - $57 | 536% |
| Universal Healthcare | $91 - $100 | 937% |
| Coventry Kc Mo | $107 - $117 | 1102% |
| College Park Family Care Center | $112 - $123 | 1153% |
| Cco, Inc. | $195 - $214 | 2008% |
| Focus Healthcare Mgmt, Inc | $195 - $214 | 2008% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Overland Park Reg Med Ctr, the cash price is $273.00, which matches the facility's cash median. This rate is significantly lower than the negotiated rates charged to insurance plans, with the lowest negotiated amount being $48.00 and the highest reaching $214.00 across various payers. While commercial insurance contracts often cap charges, patients with high-deductible plans may find paying cash directly more affordable if their out-of-pocket costs exceed the cash price. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in higher total costs than paying cash upfront.
The facility's pricing is benchmarked against Medicare, which sets the rate at $9.71. The cash price of $273.00 represents a 4.9x markup compared to this federal baseline, illustrating the difference between government-set costs and commercial pricing. To minimize potential balance billing, patients should confirm whether the facility is in-network for their specific plan, as out-of-network services at in-network hospitals can sometimes trigger unexpected bills for the difference between the provider's chargemaster and the insurance allowed amount. Additionally, patients should request a prompt-pay discount or self-pay rate before check-in, as hospitals often offer significant reductions for upfront payment to bypass administrative claim processing fees.