Blood test, average blood sugar (A1c)
Facility: Wichita County Health Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $55
- Cash Discount Price: $48
- vs. Medicare Baseline: 5.66x 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 566% of the Medicare baseline (a markup of 466%). 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 |
|---|---|---|
| Medicaid / KanCare | $50 | 515% |
| UnitedHealthcare | $60 | 618% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Wichita County Health Center in Leoti, Kansas, the facility's cash median rate of $48.00 is lower than the state average of $50.00, making it a potentially cost-effective option for patients paying out-of-pocket. However, if you have a high-deductible plan, the cash price might not be the lowest total cost; in this case, the facility's negotiated rate of $55.00 is higher than the cash price, meaning you could save money by paying directly rather than using insurance. It is important to verify your specific deductible status before scheduling, as paying the negotiated rate without meeting your deductible could result in higher out-of-pocket expenses than anticipated.
When evaluating the cost of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's gross charge of $60.00. The Medicare amount for this procedure is $9.71, which serves as the objective baseline for fair pricing; commercial negotiated rates typically range from 200% to 300% of this figure, while fair pricing is generally defined as 120% to 150%. If you choose to pay cash, ask the billing department about prompt-pay discounts, which can reduce the bill by 20% to 50% for upfront payment, bypassing the administrative costs associated with insurance claims processing. Always request a full itemized bill before paying to ensure there are no errors or unbundled charges, as over 80% of hospital bills contain mistakes that can be corrected through a formal written dispute.