Blood test, average blood sugar (A1c)
Facility: Wilson Medical Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $36
- Cash Discount Price: $30
- vs. Medicare Baseline: 3.71x 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 371% of the Medicare baseline (a markup of 271%). 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 | $5 - $37 | 51% |
| UnitedHealthcare | $5 - $65 | 51% |
| Ambetter / Centene | $5 - $70 | 51% |
| Aetna | $5 - $70 | 51% |
| Humana | $5 - $37 | 51% |
| Cigna | $8 - $56 | 82% |
| Mulitplan-All Plans | $9 - $64 | 93% |
| Health Partners-All Plans | $9 - $64 | 93% |
| Blue Cross Blue Shield | $10 - $70 | 103% |
Consumer Guidance & Cost Commentary
For the blood test, average blood sugar (A1c) procedure at Wilson Medical Center in Neodesha, KS, the facility's cash median rate is $30.00, which is lower than the negotiated rates paid by major payers such as UnitedHealthcare ($5–$65) and Aetna ($5–$70). This cash price is also significantly lower than the Medicare benchmark of $9.71 when adjusted for the facility's specific cost structure, though the raw cash rate exceeds the base Medicare amount. Patients with high-deductible plans may find paying the $30.00 cash median more cost-effective than relying on insurance, as the negotiated rates for many commercial plans exceed this amount. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.
While the facility is a Critical Access Hospital owned by the local government, the data does not provide specific county or state average pricing for this procedure to allow for a direct comparison. However, the median amount paid by insurers ($37.00) and the median negotiated rate ($36.00) are both higher than the cash price, illustrating that commercial insurance contracts often include administrative markups that do not apply to cash payers. Because the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should verify their plan's network status to avoid unexpected charges. If a patient receives an itemized bill, they should request a full line-by-line audit to identify any unbundled codes or