Blood test, average blood sugar (A1c)
Facility: Nemaha Valley Community Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $9
- Cash Discount Price: $14
- vs. Medicare Baseline: 0.93x 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.
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 |
|---|---|---|
| Va Ccn - All Plans | $1 - $10 | 10% |
| Humana | $4 - $44 | 41% |
| Aetna | $4 - $84 | 41% |
| Partners Direct Health - All Plans | $5 - $51 | 51% |
| Celtic Comm Exch - All Plans | $5 - $48 | 51% |
| Multiplan - All Plans | $8 - $89 | 82% |
| Midlands Choice - All Plans | $9 - $94 | 93% |
| Health Partners - All Plans | $9 - $94 | 93% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Nemaha Valley Community Hospital in Seneca, KS, the cash median price is $14.00, which matches the median negotiated rate paid by insurers. This aligns closely with the Medicare benchmark of $9.71, indicating that the facility's pricing is near the federal cost baseline rather than inflated by commercial markups. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should verify their specific plan details, as cash payments can sometimes be more cost-effective than insurance claims if the negotiated rate exceeds the cash price. It is also important to note that the data reflects a specific vintage and does not include state or county average comparisons, so local market context should be confirmed directly with the hospital.
Patients should proactively inquire about self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can significantly reduce out-of-pocket costs by bypassing administrative fees and claim processing delays. Since the facility is in-network for eight major payers, including Humana and Aetna, balance billing for this service is unlikely, but patients must ensure their insurance does not submit a claim that would void any cash discount agreements. To avoid unexpected charges, consumers should request a full itemized bill containing specific CPT codes rather than accepting summary invoices, and they should dispute any errors in writing to ensure accurate billing.