Blood test, average blood sugar (A1c)
Facility: Sheridan County Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $50
- Cash Discount Price: $74
- vs. Medicare Baseline: 5.15x 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 515% of the Medicare baseline (a markup of 415%). 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 |
|---|---|---|
| Celtic Insurance | $45 | 463% |
| Blue Cross Blue Shield | $50 | 515% |
| UnitedHealthcare | $70 | 721% |
Consumer Guidance & Cost Commentary
For this blood sugar test at Sheridan County Hospital in Hoxie, Kansas, the cash price is $74.00, which matches the facility's median negotiated rate of $50.00 and the state average. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans might find paying cash directly cheaper than relying on insurance, as the negotiated rate of $50.00 is lower than the cash price but still higher than the Medicare benchmark of $9.71. It is important to note that commercial insurance contracts often include administrative overhead that inflates the baseline price by 20% to 40%, meaning the negotiated rate of $50.00 reflects these costs rather than the true cost of care.
Patients should be aware that balance billing is generally prohibited for emergency services and non-emergency services from out-of-network providers at in-network facilities under the No Surprises Act, though unexpected ancillary charges can still occur. If you receive a bill that exceeds the negotiated rate, you should request a formal itemized billing audit to identify errors, double-billing, or unbundled codes, as over 80% of hospital bills contain mistakes. Additionally, you can often reduce your final cost by asking the hospital for a prompt-pay discount before scheduling, which typically offers a 20% to 50% reduction for upfront payment, bypassing the costly claims processing cycle that insurance billing requires.