Blood test, average blood sugar (A1c)
Facility: Mercy Hospital Columbus
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $60
- Cash Discount Price: $54
- vs. Medicare Baseline: 6.18x 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 618% of the Medicare baseline (a markup of 518%). 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 |
|---|---|---|
| UnitedHealthcare | $9 - $69 | 93% |
| Humana | $9 - $79 | 93% |
| Medicaid / KanCare | $9 - $60 | 93% |
| Blue Cross Blue Shield | $9 - $60 | 93% |
| Medicare (plans) | $10 - $63 | 103% |
| Aetna | $10 - $75 | 103% |
| Health Systems Inc Contracted [320174] | $36 | 371% |
| Insurance System Inc Contracted [320465] | $36 | 371% |
| Administrative Payor Contracted [320005] | $37 | 381% |
| Mercy Hospice Okc [20252] | $60 | 618% |
| Kindful Hospice [20434] | $60 | 618% |
| Dept Of Veteran Affairs Contracted [320106] | $60 | 618% |
| Medical Associates Health Contracted [320444] | $60 | 618% |
| Home State Health Plan Contracted [320187] | $60 | 618% |
| Provider Partners Health Plans Contracted [320450] | $60 | 618% |
| Indian Health Service Contracted [320198] | $60 | 618% |
| Mercy Mgd Behavioral Health Contracted [320259] | $60 | 618% |
| Novasys Contracted [320285] | $60 | 618% |
| Cross Timbers Hospice [20098] | $60 | 618% |
| Cherokee Nation Health Serv Contracted [320066] | $60 | 618% |
| Qual Choice Contracted [320325] | $60 | 618% |
| Cigna | $60 | 618% |
| Ambetter / Centene | $60 | 618% |
| Kindful Hospice Contracted [320434] | $60 | 618% |
| Halo Hcr Inc Hospice [20432] | $60 | 618% |
| Elara Caring Aspire Hospice [20433] | $60 | 618% |
| Halo Hcr Inc Hospice Contracted [320432] | $60 | 618% |
| Centurion Of Missouri [20459] | $60 | 618% |
| Pace Of The Ozarks Contracted [320518] | $60 | 618% |
| Tricare | $60 | 618% |
| Globalhealth Contracted [320145] | $60 | 618% |
| Healthscope Contracted [320182] | $64 | 659% |
| Workers Comp [20426] | $66 - $71 | 680% |
| United Medical Resources Contracted [320454] | $69 - $79 | 711% |
| Medica Contracted [320239] | $74 | 762% |
| Mercy Benefit Admin Contracted [320251] | $75 - $79 | 772% |
| Federal Medical Center Contracted [320127] | $75 | 772% |
| Healthlink Contracted [320179] | $75 - $79 | 772% |
| First Health Contracted [320128] | $75 | 772% |
| Usa Managed Care Org Contracted [320429] | $75 | 772% |
| American Healthcare Alliance Contracted [320020] | $75 | 772% |
| Preferred Health Plan Contracted [320522] | $75 | 772% |
| Yuzu Health Contracted [320521] | $79 | 814% |
| Imagine 360 Contracted [320494] | $79 | 814% |
| 90 Degree Benefits Contracted [320436] | $79 | 814% |
| Ebms Contracted [320493] | $79 | 814% |
| Ppo Plus Contracted [320310] | $79 | 814% |
| Reflect Health Contracted [320492] | $79 | 814% |
| Edison Health Solutions Contracted [320502] | $79 | 814% |
| Private Health Care Systems Contracted [320320] | $79 | 814% |
| Aither Health Contracted [320449] | $79 | 814% |
| Point C Contracted [320238] | $79 | 814% |
| Show-Me Health Administrators Contracted [320483] | $79 | 814% |
| Benefit Management Contracted [320052] | $79 | 814% |
| Auxiant Contracted [320462] | $79 | 814% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Mercy Hospital Columbus, the cash price of $54.00 is notably lower than the facility's gross charge of $83.00 and the Medicare benchmark of $9.71. While the facility's negotiated rates for major payers like UnitedHealthcare and Humana range from $9 to $79, the cash price offers a potential savings for patients with high-deductible plans who may not have met their out-of-pocket limits. It is important to note that commercial insurance contracts often include administrative overhead that can inflate the negotiated rate above the cash price; however, patients should verify their specific plan's allowed amount before scheduling, as some in-network rates may still exceed the cash-pay option. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill if payment is made upfront, though these discounts must be requested prior to check-in to avoid automatic insurance claim submission.
The facility's cash rate of $54.00 is significantly lower than the median negotiated rate of $60.00 and the median paid amount of $60.00 reported for this service. While the data does not provide explicit county or state average comparisons for this specific code, the substantial difference between the cash price and the Medicare benchmark highlights the potential for cost savings when paying directly. Patients should be aware that balance billing is generally prohibited for emergency services and non-emergency care at in-network facilities under the No Surprises Act, but unexpected charges can still occur if ancillary services like lab tests are billed out-of-network. To ensure accuracy, consumers should request a full itemized bill before paying, as summary