Blood test, average blood sugar (A1c)
Facility: Kansas Heart Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $10
- Cash Discount Price: $53
- 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 |
|---|---|---|
| Aetna | $8 | 82% |
| Tricare | $9 | 93% |
| Humana | $10 | 103% |
| Medicaid / KanCare | $10 | 103% |
| Celtic Mcr Adv | $10 | 103% |
| UnitedHealthcare | $10 | 103% |
| Blue Cross Blue Shield | $24 | 247% |
| Wppa - All Plans | $34 | 350% |
| Multiplan - All Plans | $76 | 783% |
Consumer Guidance & Cost Commentary
For the CPT code 83036, representing an average blood sugar (A1c) test, Kansas Heart Hospital in Wichita, KS, has a gross charge of $85.00. While the facility's cash median price is $53.00 and the median negotiated rate across payers is $10.00, the Medicare benchmark for this service is significantly lower at $9.71. This indicates that the facility's negotiated rates are only slightly above the federal baseline, suggesting a transparent pricing structure compared to the typical commercial markup range of 200% to 300% of Medicare. Patients with high-deductible plans may find the cash price of $53.00 more advantageous than the negotiated rate, as paying upfront can bypass administrative fees and potential deductibles, provided they secure a prompt-pay discount before the claim is submitted.
The facility offers this service to nine different payers, including Aetna, Tricare, and Humana, with negotiated rates ranging from $8.00 to $76.00 depending on the specific insurance plan. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan's allowed amount before scheduling. To minimize costs, consumers are encouraged to contact the hospital directly to confirm "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within 30 days. Additionally, patients should request an itemized bill to ensure no unbundled codes or services not rendered are included, as summary bills often obscure