Blood test, average blood sugar (A1c)
Facility: Hamilton County Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $84
- Cash Discount Price: $93
- vs. Medicare Baseline: 8.65x 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 865% of the Medicare baseline (a markup of 765%). 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 | $17 - $36 | 175% |
| First Health Coventry - All Plans | $79 | 814% |
| Cigna | $88 | 906% |
| UnitedHealthcare | $88 | 906% |
| Va Ccn - All Plans | $93 | 958% |
| Aetna | $158 | 1627% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Hamilton County Hospital in Syracuse, KS, the cash median price is $93.00, which matches the facility's gross charge. This rate is significantly higher than the state average, as indicated by the 8.7% variance against Medicare benchmarks, and exceeds the median negotiated rate of $84.00 paid by commercial payers. While the facility is a government-owned Critical Access Hospital, patients should be aware that cash-pay options can sometimes be more cost-effective than insurance claims if their plan's negotiated rate exceeds the cash price. Given that the cash price is already at the gross level, it is important to verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can reduce the final amount owed.
The Medicare benchmark for this service is $9.71, which serves as the objective baseline for evaluating pricing markups. Although the facility's cash rate is much higher than the Medicare amount, commercial payers negotiate rates that average between $17 and $158 depending on the specific plan, with most falling between $79 and $93. Patients should avoid relying on summary bills that only show broad category totals, as these can obscure individual code costs. Instead, requesting a full itemized CPT-coded bill allows you to identify any unbundled charges or services not rendered, ensuring you are only paying for what was actually provided. If you encounter a large bill, disputing errors in writing with the billing supervisor is the most effective way to reduce medical debt, rather than accepting verbal assurances from customer service.