Blood test, average blood sugar (A1c)
Facility: Wamego Health Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $10
- Cash Discount Price: $70
- vs. Medicare Baseline: 1.03x 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.
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 | $10 | 103% |
| Providrs Care | $10 | 103% |
| Medicaid / KanCare | $10 | 103% |
| Aetna | $10 | 103% |
| Blue Cross Blue Shield | $150 - $158 | 1545% |
Consumer Guidance & Cost Commentary
For the CPT code 83036, representing an average blood sugar (A1c) test, the facility's cash median price is $70.00, while the negotiated rates for in-network payers range from $10.00 to $158.00. It is important to note that for patients with high-deductible plans, paying the cash price of $70.00 upfront can sometimes be more cost-effective than relying on insurance, as the negotiated rates for some commercial payers exceed the cash amount. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by up to 50% if paid in full within a short window.
This specific service is priced at $9.71 under the Medicare benchmark, which serves as a scientifically validated baseline for healthcare costs. The facility's cash rate of $70.00 is significantly higher than the Medicare amount, reflecting the administrative overhead and profit margins inherent in commercial billing structures. While the data does not provide specific state or county average comparisons for this exact procedure, understanding that commercial negotiated rates often average 200% to 300% of Medicare helps patients evaluate whether the facility's pricing aligns with fair market value. To ensure you are not overcharged, always request an itemized bill before payment to identify any unbundled codes or services not rendered.