Blood test, average blood sugar (A1c)
Facility: Norton County Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $50
- Cash Discount Price: $41
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $50 | 515% |
Consumer Guidance & Cost Commentary
For this blood sugar test at Norton County Hospital, the cash price of $41.00 is notably lower than the facility's negotiated rate of $50.00 and the state average of $50.00. While commercial insurance plans often pay negotiated rates that can exceed cash prices, patients with high-deductible plans may find paying out-of-pocket cheaper if their deductible has not yet been met. It is important to verify your specific plan's allowed amount before scheduling, as some in-network facilities charge significantly more than others. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final cost by bypassing administrative fees associated with insurance billing.
This service is benchmarked against Medicare, which sets a fixed reimbursement rate of $9.71 for this procedure. The facility's cash price of $41.00 represents a significant markup over the Medicare baseline, illustrating how commercial rates often differ from federal cost standards. Because over 80% of hospital bills contain errors, patients should request a full itemized statement rather than accepting a summary bill, which may hide unbundled charges or services not rendered. If you receive a balance bill for an out-of-network service, you are protected under the No Surprises Act, which prohibits providers from billing you for the difference between their full charge and your insurance's allowed amount.