Blood test, average blood sugar (A1c)
Facility: Cloud County Health Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $117
- Cash Discount Price: $89
- vs. Medicare Baseline: 12.05x 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 1205% of the Medicare baseline (a markup of 1105%). 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 |
|---|---|---|
| Mpi-All Plans | $13 - $117 | 134% |
| Aetna | $111 - $115 | 1143% |
| Pponext-All Plans | $117 - $125 | 1205% |
| Health Partners - All Plans | $117 | 1205% |
Consumer Guidance & Cost Commentary
For this blood sugar test at Cloud County Health Center in Concordia, KS, the facility's cash price of $89.00 is lower than the state average of $117.00, making it a potentially cost-effective option for patients with high-deductible plans or those paying out-of-pocket. While the facility's negotiated rate with major payers like Aetna and Mpi-All Plans is $117.00, this amount exceeds the cash price, suggesting that paying directly could save money if you have not yet met your insurance deductible. It is important to note that commercial insurance rates often include administrative overhead and do not reflect the true cost of care, which is better represented by the Medicare benchmark of $9.71. To maximize savings, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final amount owed.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, unexpected charges can still occur if ancillary services like lab tests are billed by out-of-network providers. If you receive a bill that seems higher than expected, you have the right to request a formal itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Do not accept summary bills that only show broad category totals; instead, demand a detailed statement with specific CPT codes to verify the charges. If a balance bill arises from an out-of-network provider, you can dispute the amount with your insurer and request a No Surprises Act audit rather than paying immediately, which may