Blood test, average blood sugar (A1c)
Facility: Mercy Specialty Hospital Southeast Kansas
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $21
- Cash Discount Price: $96
- vs. Medicare Baseline: 2.16x 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 216% of the Medicare baseline (a markup of 116%). 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 |
|---|---|---|
| United Medical Resources Contracted [320454] | $8 - $27 | 82% |
| First Health Contracted [320128] | $8 | 82% |
| UnitedHealthcare | $8 - $136 | 82% |
| Aetna | $8 - $10 | 82% |
| Blue Cross Blue Shield | $9 - $26 | 93% |
| Medica Contracted [320239] | $9 | 93% |
| Medicaid / KanCare | $9 - $14 | 93% |
| Humana | $9 - $10 | 93% |
| Medical Associates Health Contracted [320444] | $10 | 103% |
| Cigna | $10 - $55 | 103% |
| Qual Choice Contracted [320325] | $10 | 103% |
| Halo Hcr Inc Hospice [20432] | $10 | 103% |
| Pace Of The Ozarks Contracted [320518] | $10 | 103% |
| Mercy Mgd Behavioral Health Contracted [320259] | $10 | 103% |
| Halo Hcr Inc Hospice Contracted [320432] | $10 | 103% |
| Dept Of Veteran Affairs Contracted [320106] | $10 | 103% |
| Cherokee Nation Health Serv Contracted [320066] | $10 | 103% |
| Elara Caring Aspire Hospice [20433] | $10 | 103% |
| Provider Partners Health Plans Contracted [320450] | $10 | 103% |
| Globalhealth Contracted [320145] | $10 | 103% |
| Mercy Hospice Okc [20252] | $10 | 103% |
| Kindful Hospice [20434] | $10 | 103% |
| Tricare | $10 | 103% |
| Medicare (plans) | $10 | 103% |
| Kindful Hospice Contracted [320434] | $10 | 103% |
| Cross Timbers Hospice [20098] | $10 | 103% |
| Centivo Contracted [320505] | $16 | 165% |
| Providrs Care Network Contracted [320484] | $18 | 185% |
| Health Systems Inc Contracted [320174] | $27 | 278% |
| Healthscope Contracted [320182] | $27 - $110 | 278% |
| Benefit Management Contracted [320052] | $27 | 278% |
| Point C Contracted [320238] | $27 - $110 | 278% |
| Insurance System Inc Contracted [320465] | $27 | 278% |
| Mercy Benefit Admin Contracted [320251] | $60 - $103 | 618% |
| Show-Me Health Administrators Contracted [320483] | $60 | 618% |
| American Healthcare Alliance Contracted [320020] | $103 | 1061% |
| Edison Health Solutions Contracted [320502] | $103 | 1061% |
| Aither Health Contracted [320449] | $103 | 1061% |
| Auxiant Contracted [320462] | $103 - $110 | 1061% |
| Reflect Health Contracted [320492] | $103 | 1061% |
| Ebms Contracted [320493] | $103 | 1061% |
| Yuzu Health Contracted [320521] | $103 | 1061% |
| Imagine 360 Contracted [320494] | $103 | 1061% |
| Preferred Health Plan Contracted [320522] | $110 | 1133% |
| Federal Medical Center Contracted [320127] | $110 | 1133% |
| Healthlink Contracted [320179] | $110 | 1133% |
| Compcare Of The Ozarks Contracted [320437] | $116 | 1195% |
| Workers Comp [20426] | $118 | 1215% |
| Private Health Care Systems Contracted [320320] | $136 | 1401% |
| Multiplan Contracted [320270] | $140 | 1442% |
| Multiplan [20270] | $140 | 1442% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Mercy Specialty Hospital Southeast Kansas, the facility's cash median price of $96.00 is notably higher than the state average of $17.00 for this procedure. While commercial insurance plans typically negotiate rates ranging from $8 to $140 depending on the carrier, the cash price remains a significant factor for patients with high-deductible plans or those without coverage. In such cases, paying the full cash price of $96.00 upfront can sometimes be more cost-effective than relying on insurance, which may result in a negotiated rate that exceeds the cash amount due to administrative overhead and contract structures. Patients are encouraged to explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%.
To ensure you are not overcharged, it is critical to request a detailed, itemized bill rather than accepting a summary invoice that groups services into broad categories. Over 80% of hospital bills contain errors, including double-billing or unbundled charges, and a formal written audit dispute sent to the billing supervisor is the most effective way to resolve these issues. Furthermore, your commercial rate should be evaluated against the Medicare benchmark of $9.71, which represents the federal government's fixed reimbursement rate and serves as a scientifically validated baseline for the true cost of care. Comparing your negotiated rate to this Medicare amount reveals the facility's markup, helping you understand if the commercial price is fair or inflated compared to the actual cost of delivering this service.