Blood test, average blood sugar (A1c)
Facility: Holton Community Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $45
- Cash Discount Price: $44
- vs. Medicare Baseline: 4.63x 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 463% of the Medicare baseline (a markup of 363%). 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 | $28 - $64 | 288% |
| Aetna | $28 - $64 | 288% |
| Humana | $28 - $35 | 288% |
| Kansas Superior Select - All Plans | $29 - $35 | 299% |
| Blue Cross Blue Shield | $36 | 371% |
| Preferred Health Freedom | $44 - $54 | 453% |
| Preferred Health Professionals | $44 - $54 | 453% |
| Preferred Health Fn Select - All Other Plans | $44 - $54 | 453% |
| Wppa Providers - All Plans | $50 - $61 | 515% |
| Medicaid / KanCare | $53 - $64 | 546% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Holton Community Hospital, the cash median price is $44.00, which is lower than the facility's negotiated rates of $45.00 and the gross charge of $59.00. This cash price is also lower than the Medicare benchmark of $9.71 when adjusted for the facility's specific pricing context, though it is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates paid by insurers like UnitedHealthcare and Aetna range from $28 to $64, potentially leaving the patient responsible for significant out-of-pocket costs if their deductible has not been met.
To ensure you are not overcharged, it is recommended to ask the hospital specifically about "self-pay" or "prompt-pay" discounts before scheduling your visit, as these upfront payment incentives can reduce the final bill by 20% to 50%. If you do receive a bill, always request a full itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If you encounter a balance bill from an out-of-network provider, remember that the No Surprises Act generally protects you from paying the difference between the provider's full charge and your insurance allowed amount for emergency or non-emergency services at in-network facilities, so you should dispute any unexpected charges in writing rather than paying immediately.