Blood test, average blood sugar (A1c)
Facility: Rooks County Health Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $106
- Cash Discount Price: $88
- vs. Medicare Baseline: 10.92x 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 1092% of the Medicare baseline (a markup of 992%). 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 |
|---|---|---|
| Veterans Admin - All Plans | $11 | 113% |
| Blue Cross Blue Shield | $36 | 371% |
| Tricare | $55 | 566% |
| Celtic Mcr Adv | $55 | 566% |
| Celtic Comm - All Other Plans | $61 | 628% |
| Aetna | $106 | 1092% |
| UnitedHealthcare | $106 | 1092% |
| Preferred Benefits Admin | $106 | 1092% |
| Preferred Hlthcare - All Other Plans | $112 | 1153% |
| Health Partners - All Plans | $112 | 1153% |
| Healthy Blue Mcaid - All Plans | $118 | 1215% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Rooks County Health Center in Plainville, KS, the cash price of $88.00 is notably lower than the facility's negotiated rate of $106.00 and the Medicare benchmark of $9.71. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance negotiated rate exceeds the cash price. It is important to note that the cash rate of $88.00 is significantly higher than the state average for this service, which suggests that while the facility offers a discount compared to its own insurance contracts, the overall pricing structure in this region remains elevated. Patients should always verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can further reduce the final amount owed.
The data indicates that the facility's cash rate of $88.00 is also higher than the median paid amount of $83.00, which represents the average amount commercial payers actually reimburse for this procedure. This discrepancy highlights the importance of understanding that commercial negotiated rates often include administrative overhead and contract dynamics that push prices well above the true cost of care, as reflected in the Medicare benchmark. To ensure you are not overpaying, it is advisable to request an itemized billing audit before finalizing payment, as summary bills often obscure individual code costs and potential errors. By comparing the facility's rates directly to the Medicare benchmark and understanding the difference between negotiated and cash prices, you can make informed decisions that protect your financial interests without relying on inflated chargemaster lists.