Blood test, average blood sugar (A1c)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $47
- Cash Discount Price: $50
- vs. Medicare Baseline: 4.84x 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 484% of the Medicare baseline (a markup of 384%). 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 |
|---|---|---|
| Tricare | $38 - $40 | 391% |
| Aetna | $43 - $50 | 443% |
| Humana | $43 - $46 | 443% |
| Hpk-All Plans | $45 - $48 | 463% |
| UnitedHealthcare | $45 - $48 | 463% |
| Medicaid / KanCare | $47 - $50 | 484% |
Consumer Guidance & Cost Commentary
For the CPT code 83036, representing an average blood sugar (A1c) test, Medicine Lodge Memorial Hospital lists a cash median price of $50.00, which matches the facility's gross charge. While the hospital is a Critical Access Hospital in Medicine Lodge, KS, and is owned by a Government Hospital District, the data does not provide specific county or state average figures for this procedure to compare against. However, the facility's negotiated rates with major payers such as Aetna, Humana, and UnitedHealthcare range between $43.00 and $50.00, while Medicaid/KanCare plans see a negotiated rate of $47.00. These negotiated amounts are generally higher than the cash price, illustrating a common billing dynamic where paying out-of-pocket can sometimes result in lower costs than what insurance plans are contractually allowed to pay.
Patients should be aware that commercial insurance rates often include administrative overhead and contract markups, which can make the cash price the most economical option for those with high-deductible plans or no coverage. Although the data does not show a specific Medicare benchmark for this code, the facility's cash rate aligns with the gross charge, and patients are encouraged to verify if "self-pay" or "prompt-pay" discounts are available before scheduling. If you have insurance, it is important to confirm your deductible status, as paying the negotiated rate may not be covered until that threshold is met. For those without insurance, requesting a waiver of insurance submission at registration can prevent the hospital from submitting a claim that might void any cash discount agreements.