Blood test, average blood sugar (A1c)
Facility: Ashland Health Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $54
- Cash Discount Price: $49
- vs. Medicare Baseline: 5.56x 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 556% of the Medicare baseline (a markup of 456%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $17 - $24 | 175% |
| Compalliance-All Plans | $41 - $58 | 422% |
| Health Partners Of Kansas-All Plans | $43 - $61 | 443% |
| Multiplan-All Plans | $50 - $71 | 515% |
| Health Choice-All Plans | $51 - $72 | 525% |
| UnitedHealthcare | $51 - $72 | 525% |
| Medicare (plans) | $51 - $72 | 525% |
| Medicaid / KanCare | $51 - $72 | 525% |
| Medica Mcare - All Plans | $51 - $72 | 525% |
| Aetna | $51 - $72 | 525% |
| Healthy Blue Mcr Adv - All Other Plans | $51 - $72 | 525% |
| Providers Care (Wppa)-All Plans | $76 - $108 | 783% |
Consumer Guidance & Cost Commentary
For the CPT code 83036, representing an average blood sugar (A1c) test, Ashland Health Center in Ashland, KS, lists a gross charge of $62.00. While the facility's cash median is $49.00 and the median negotiated rate across payers is $54.00, the Medicare benchmark rate is significantly lower at $9.71. This disparity highlights the importance of comparing commercial rates against the federal baseline rather than the hospital's full list price. Although the negotiated rates for major insurers like UnitedHealthcare and Aetna range between $51.00 and $72.00, these figures often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash median of $49.00 directly, provided they secure a prompt-pay discount before the insurance claim is processed.
The facility, a Critical Access Hospital, reports a median negotiated payment of $54.00, which serves as a reference point for commercial pricing. However, without specific county or state average data provided in the current dataset, patients should focus on the transparency of the cash versus negotiated rates to avoid unexpected costs. It is crucial to verify the status of your deductible before scheduling, as paying the negotiated rate of $54.00 may result in out-of-pocket expenses if the plan has not yet met its threshold. To ensure you are receiving the best possible rate, patients should explicitly request self-pay or prompt-pay discounts prior to check-in and insist on an itemized bill to confirm that no services were rendered or bundled incorrectly, thereby protecting against potential balance billing or administrative overcharges.