Blood test, average blood sugar (A1c)
Facility: Stanton County Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $94
- Cash Discount Price: $74
- vs. Medicare Baseline: 9.68x 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 968% of the Medicare baseline (a markup of 868%). 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 - $230 | 350% |
| Healthy Blue Mcr Adv - All Other Plans | $93 - $238 | 958% |
| Healthy Blue Mcaid | $94 - $207 | 968% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Stanton County Hospital in Johnson, KS, the cash price of $74.00 is significantly lower than the facility's negotiated rates with major payers, which range from $93 to $238. While the hospital is a Critical Access Hospital with government-local ownership, patients should be aware that commercial insurance contracts often include administrative overhead that inflates the baseline price by 20% to 40%. If you have a high-deductible plan, paying the cash price upfront might be more cost-effective than relying on insurance, as the negotiated rate could exceed the cash price before your deductible is met. It is always advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid in full before or shortly after the service.
When evaluating the cost of this service, it is important to compare rates against the Medicare benchmark rather than the hospital's gross charge list. The Medicare amount for this procedure is $9.71, which serves as the objective baseline for evaluating pricing markups. Although the facility's cash rate of $74.00 is higher than the Medicare rate, commercial negotiated rates typically average 200% to 300% of this baseline, while fair pricing is generally defined as 120% to 150%. By focusing on the Medicare rate of $9.71, you can better understand the true cost of care and avoid being misled by large discounts calculated off inflated chargemaster lists.