Blood test, average blood sugar (A1c)
Facility: Kearny County Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $97
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 9.99x 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 999% of the Medicare baseline (a markup of 899%). 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 |
|---|---|---|
| Pan-American Life Insurance Co | $97 | 999% |
| Humana | $97 | 999% |
| Luminare Health | $97 | 999% |
| Wps Gha - Mac J5 Part A | $97 | 999% |
| Aetna | $97 | 999% |
| UnitedHealthcare | $97 | 999% |
| Blue Cross Blue Shield | $97 | 999% |
| Benefit Plan Administrators | $97 | 999% |
| Community Care Health Plan Of | $97 | 999% |
| Meritain Health | $97 | 999% |
Consumer Guidance & Cost Commentary
For the CPT code 83036, representing an average blood sugar (A1c) test at Kearny County Hospital in Lakin, Kansas, the negotiated payment rate is $97.00 across all ten commercial payers listed, including UnitedHealthcare and Aetna. This negotiated amount is significantly higher than the Medicare benchmark of $9.71, reflecting the standard administrative markup inherent in commercial insurance contracts. However, the facility's cash median price is not listed in this report, which is important for patients with high-deductible plans who may find paying out-of-pocket cheaper if the cash rate falls below the $97.00 insurance allowed amount. Because the facility is a government-owned Critical Access Hospital, patients should proactively ask about self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can bypass the higher administrative costs associated with insurance billing cycles.
The data indicates that while the negotiated rate is uniform at $97.00 for all insurers, the actual amount paid by the facility varies, with a median paid amount of $46.00. This discrepancy highlights that the final cost to the patient depends heavily on their specific plan's deductible status and the facility's internal payment terms. Given that balance billing is generally prohibited for in-network services at this facility under federal protections, patients should avoid paying surprise bills immediately and instead request a formal, itemized billing audit to verify all charges. By comparing the facility's rates directly to the Medicare baseline and inquiring about cash discounts prior to check-in, consumers can ensure they are not overpaying for a routine laboratory service.