Blood test, average blood sugar (A1c)
Facility: Clara Barton Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $48
- Cash Discount Price: $55
- vs. Medicare Baseline: 4.94x 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 494% of the Medicare baseline (a markup of 394%). 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 |
|---|---|---|
| 6 Degrees Health - All Plans | $36 - $74 | 371% |
| Blue Cross Blue Shield | $36 | 371% |
| Wppa-All Plans | $42 - $84 | 433% |
| UnitedHealthcare | $47 - $94 | 484% |
| Aetna | $47 - $94 | 484% |
| Phcs - All Plans | $47 - $94 | 484% |
| Hlth Partners Of Ks-All Plans | $48 - $97 | 494% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Clara Barton Hospital in Hoisington, KS, the cash median price is $55.00, which is lower than the facility's negotiated rates of $48.00 to $97.00 across various insurance plans. While the hospital is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance often results in higher out-of-pocket costs due to administrative overhead and contract dynamics. In this specific case, the cash price is notably lower than the average negotiated rates, meaning patients with high-deductible plans or those without insurance may save money by paying directly rather than relying on insurance coverage, provided they secure the cash rate upfront.
To maximize savings, patients should proactively request self-pay or prompt-pay discounts before scheduling their visit, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is crucial to avoid automatic claims submission, which can void cash agreements, and instead sign a waiver of insurance submission to ensure the facility applies the lower cash rate. Additionally, since the facility is located in a Critical Access Hospital setting, patients should verify that all ancillary services, such as lab draws, are covered under the No Surprises Act to prevent unexpected balance billing, and always demand a full itemized bill to identify any errors or unbundled charges before making a payment.