Blood test, average blood sugar (A1c)
Facility: Ellinwood District Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $41
- Cash Discount Price: $50
- vs. Medicare Baseline: 4.22x 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 422% of the Medicare baseline (a markup of 322%). 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 |
|---|---|---|
| Humana | $39 - $48 | 402% |
| UnitedHealthcare | $39 - $48 | 402% |
| Blue Cross Blue Shield | $39 - $48 | 402% |
| Cigna | $39 - $48 | 402% |
| Aetna | $39 - $48 | 402% |
Consumer Guidance & Cost Commentary
For the CPT code 83036, representing an average blood sugar (A1c) test, Ellinwood District Hospital in Ellinwood, KS, lists a gross charge of $59.00. The facility's cash median price is $50.00, which is notably lower than the state average of $59.00. While the hospital's negotiated rates with major payers like Humana, UnitedHealthcare, and Blue Cross Blue Shield range between $39.00 and $48.00, these amounts are still higher than the cash price. For patients with high-deductible plans, paying the $50.00 cash median directly may result in lower out-of-pocket costs compared to having insurance cover the service, as the negotiated rates often exceed the cash price.
To ensure you are receiving the most accurate pricing, it is crucial to request an itemized bill before finalizing payment, as summary bills can obscure individual line items and potential errors. Additionally, patients should inquire about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if paid in full upfront, bypassing the administrative overhead associated with insurance claims. When comparing this facility's pricing to the national standard, the Medicare benchmark for this service is $9.71; the hospital's cash rate of $50.00 represents a significant markup over the federal baseline, highlighting the importance of verifying self-pay rates and asking for written confirmation of any discounts before scheduling your visit.