Blood test, average blood sugar (A1c)
Facility: Greenwood County Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $79
- Cash Discount Price: $75
- vs. Medicare Baseline: 8.14x 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 814% of the Medicare baseline (a markup of 714%). 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 | $9 - $79 | 93% |
| Triwest - All Plans | $34 | 350% |
| Blue Cross Blue Shield | $34 - $36 | 350% |
| Tricare | $39 | 402% |
| Choicecare Mcr Adv - All Plans | $39 | 402% |
| Integrated Health Plan - All Plans | $70 | 721% |
| First Health Ccn Network | $80 | 824% |
| First Health - All Other Plans | $80 | 824% |
| Beech Street - All Plans | $80 | 824% |
| Preferred Hs (Coventry) - All Plans | $85 | 875% |
| Principal Health Care Inc - All Plans | $89 | 917% |
| Medicaid / KanCare | $94 | 968% |
| Amerigroup Mcaid-All Plans | $94 | 968% |
| Providrs Care/Wppa - All Plans | $141 | 1452% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Greenwood County Hospital, the facility's cash median rate of $75.00 is lower than the state average of $79.00 and matches the median negotiated rate for most major payers. While commercial insurance contracts often result in higher allowed amounts than cash prices, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurer's negotiated rate exceeds the cash price. To secure the lowest possible cost, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can significantly reduce the final bill by bypassing administrative claim processing fees.
It is important to distinguish between the facility's gross charge of $94.00 and the actual rates patients will face, as the gross amount represents the maximum list price before any discounts or insurance negotiations are applied. The Medicare benchmark rate of $9.71 serves as a critical baseline for evaluating pricing fairness, revealing that commercial rates are typically marked up significantly above this federal cost standard. If a patient receives an itemized bill that includes unexpected charges or uses a summary invoice, they should request a full line-by-line audit to identify errors, unbundled codes, or services not rendered, ensuring they are only paying for the care actually provided.