Blood test, average blood sugar (A1c)
Facility: Graham County Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $38
- Cash Discount Price: $55
- vs. Medicare Baseline: 3.91x 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 391% of the Medicare baseline (a markup of 291%). 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 | $5 - $52 | 51% |
| Medicaid / KanCare | $16 | 165% |
| Blue Cross Blue Shield | $36 | 371% |
| Medicare (plans) | $41 | 422% |
| Celtic Commercial-All Other Plans | $45 | 463% |
| Wppa (Providers Care)-All Plans | $52 | 536% |
Consumer Guidance & Cost Commentary
For this blood sugar test (CPT 83036) at Graham County Hospital in Hill City, Kansas, the cash price is $55.00, which matches the facility's median negotiated rate. This cash price is significantly lower than the state average for this procedure, offering a clear financial advantage for patients paying out-of-pocket. While many commercial payers have negotiated rates ranging from $16 to $52, these amounts often exceed the cash price due to administrative overhead and contract structures. If you have a high-deductible plan or have not yet met your deductible, paying the $55.00 cash rate directly may result in lower out-of-pocket costs compared to your insurance's allowed amount, which can sometimes be higher than the cash price.
To ensure you are not overcharged, it is essential to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, you should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if paid in full upfront. If you receive a balance bill from an out-of-network provider, remember that the No Surprises Act protects you from paying the difference between the provider's full charge and your insurance's allowed amount for emergency care and non-emergency services at in-network facilities. Always verify your specific plan details and request a written audit dispute if you believe any charges are incorrect.