Blood test, average blood sugar (A1c)
Facility: Stafford County Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $43
- Cash Discount Price: $62
- vs. Medicare Baseline: 4.43x 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 443% of the Medicare baseline (a markup of 343%). 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 |
|---|---|---|
| Va Ccn-All Plans | $4 - $8 | 41% |
| UnitedHealthcare | $4 - $8 | 41% |
| Health Partners-All Plans | $42 - $77 | 433% |
| Medica Mcr- All Plans | $44 - $81 | 453% |
| Humana | $44 - $81 | 453% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Stafford County Hospital, the cash price is $62.00, which matches the facility's median paid amount. This rate is significantly lower than the state average, as the facility's negotiated rate of $43.00 sits well below the typical commercial pricing seen across Kansas. While Medicare sets a baseline reimbursement of $9.71 for this service, commercial insurance plans negotiate rates that often range from 4% to 81% of the gross charge depending on the carrier. For patients with high-deductible plans, paying the cash price of $62.00 upfront may be more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the deductible has not yet been met.
Patients should verify their specific plan details before scheduling, as negotiated rates vary widely among payers, with some plans paying as little as 4% of the gross charge while others pay up to 81%. It is important to ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full before or shortly after the service. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request an itemized bill to ensure no errors or unbundled charges are included. Always confirm your deductible status and request a written waiver of insurance submission if you choose to pay cash directly to avoid unexpected claims processing fees.