Blood test, average blood sugar (A1c)
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $10
- Cash Discount Price: $71
- 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 |
|---|---|---|
| United Mine Workers Of America | $10 | 103% |
| Aetna | $10 - $12 | 103% |
| Humana | $10 | 103% |
| Providrs Care Network | $10 | 103% |
| Blue Cross Blue Shield | $10 | 103% |
| UnitedHealthcare | $10 - $12 | 103% |
| Lantern Specialty Care | $16 | 165% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Kansas Spine & Specialty Hospital, the cash median price is $71.00, which is significantly lower than the facility's negotiated rates of $10.00 and the Medicare benchmark of $9.71. While the facility is located in Wichita, KS, and serves seven payers including UnitedHealthcare and Aetna, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance negotiated rate exceeds the cash price. It is important to note that the facility is owned by a physician group, and while the data shows a median paid amount of $25.00, this figure likely reflects insurance reimbursement rather than the final patient responsibility, which could be lower with prompt-pay discounts.
To minimize costs, patients should explicitly request a self-pay classification and prompt-pay discount before scheduling, as waiting until after receiving a bill often results in missing these upfront fee reductions. Although the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details to avoid unexpected charges. Given that over 80% of hospital bills contain errors, consumers are advised to demand a full itemized CPT-coded statement rather than accepting a summary bill, ensuring they can identify any unbundled codes or services not rendered before finalizing payment.