Blood test, average blood sugar (A1c)
Facility: Hiawatha Community Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $76
- Cash Discount Price: $97
- vs. Medicare Baseline: 7.83x 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 783% of the Medicare baseline (a markup of 683%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $34 - $36 | 350% |
| Aetna | $36 - $78 | 371% |
| UnitedHealthcare | $36 - $83 | 371% |
| Humana | $36 | 371% |
| Ambetter / Centene | $43 | 443% |
| Centrus Health Direct - All Plans | $73 | 752% |
| Oscar - All Plans | $73 | 752% |
| Preferred Hlth - All Plans | $87 | 896% |
| Cigna | $92 | 947% |
| Wppa Providrs Care - All Plans | $92 | 947% |
| Multiplan - All Plans | $94 | 968% |
| Midlands Choice - All Plans | $94 | 968% |
| Healthy Blue Mcaid - All Plans | $97 | 999% |
Consumer Guidance & Cost Commentary
For the blood test, average blood sugar (A1c) procedure at Hiawatha Community Hospital in Hiawatha, KS, the cash median price is $97.00, which matches the facility's gross charge. This cash rate is significantly lower than the state average for this service, as indicated by the 7.8% variance compared to Medicare benchmarks. While the facility is a Critical Access Hospital owned by a voluntary non-profit, patients with high-deductible plans may find the cash price more affordable than their insurance negotiated rates. For instance, while Aetna and UnitedHealthcare have negotiated ranges starting at $36 and $36 respectively, the cash price of $97.00 remains a fixed benchmark that could be lower than the final out-of-pocket cost if a patient's deductible has not yet been met.
Patients should be aware that commercial insurance negotiated rates often include administrative overhead and do not always reflect the lowest possible cost for the service. At this facility, the median negotiated amount across payers is $76.00, which is lower than the cash price, but individual plan allowances can vary widely, with some plans ranging up to $97.00. To potentially reduce costs further, patients should inquire about prompt-pay discounts, which can offer a fee reduction of 20% to 50% for upfront payment, effectively bypassing the administrative costs associated with insurance claims processing. Additionally, since over 80% of hospital bills contain errors, patients are encouraged to request a detailed, itemized billing audit before paying any balance bill, ensuring that all charges are accurate and that no services were unbundled or incorrectly coded.