Blood test, average blood sugar (A1c)
Facility: Kansas City Orthopaedic Institute
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $25
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.57x 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 257% of the Medicare baseline (a markup of 157%). 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 | $10 | 103% |
| UnitedHealthcare | $10 | 103% |
| Aetna | $10 | 103% |
| Blue Cross Blue Shield | $25 | 257% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Kansas City Orthopaedic Institute in Leawood, KS, the data indicates a median negotiated rate of $25.00, which is significantly higher than the Medicare benchmark of $9.71. While the facility is a Physician-owned Acute Care Hospital, the report does not provide specific cash or state/county average figures for this procedure, so direct comparisons to local market rates cannot be made. However, patients should be aware that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures; if you have a high-deductible plan, paying the cash price directly might result in lower out-of-pocket costs compared to your insurance's negotiated rate, provided you qualify for self-pay discounts.
To ensure you are not overcharged, it is critical to request a full itemized bill before finalizing payment, as summary bills often obscure individual line items and potential errors. If you receive a bill, verify that all services rendered are listed with specific CPT codes and that no unbundled charges or services not delivered are included. Additionally, since the facility offers a prompt-pay discount for upfront payments, you should contact the billing department before scheduling to confirm the self-pay rate and request a waiver of insurance submission to avoid automatic claims processing that could void your cash discount.