Blood test, average blood sugar (A1c)
Facility: F W Huston Medical Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $85
- Cash Discount Price: $88
- vs. Medicare Baseline: 8.75x 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 875% of the Medicare baseline (a markup of 775%). 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 | $36 | 371% |
| Aetna | $82 | 844% |
| Humana | $87 | 896% |
| Cigna | $94 | 968% |
Consumer Guidance & Cost Commentary
For the CPT code 83036, representing an average blood sugar (A1c) test, F W Huston Medical Center in Winchester, KS, lists a cash median price of $88.00 and a median negotiated rate of $85.00. This facility, a Critical Access Hospital, reports a Medicare benchmark of $9.71, which serves as the federal baseline for evaluating pricing fairness. While the facility's cash rate is significantly higher than the Medicare benchmark, it is important to note that commercial insurance plans often negotiate rates that can exceed cash prices; for instance, the highest negotiated rate among the four listed payers is $94.00. Because cash-pay options can sometimes be more cost-effective for patients with high-deductible plans when insurance negotiated rates are inflated, patients should verify their specific plan's allowed amount before scheduling. Additionally, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final balance by 20% to 50% if paid upfront, bypassing the administrative costs associated with insurance claims processing.
When reviewing your final invoice, ensure you receive a detailed itemized bill rather than a summary statement, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a summary bill showing broad categories like "Laboratory," request a full line-by-line CPT-coded statement before negotiating or paying to identify any discrepancies. Furthermore, avoid using the hospital's gross chargemaster list as a benchmark for savings, as these inflated list prices do not reflect the true cost of care; instead, compare your negotiated or cash rate against the