Blood test, average blood sugar (A1c)
Facility: Decatur Health
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $49
- Cash Discount Price: $54
- vs. Medicare Baseline: 5.05x 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 505% of the Medicare baseline (a markup of 405%). 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 |
|---|---|---|
| Wppa/Providrs Care- All Plans | $32 - $40 | 330% |
| UnitedHealthcare | $33 - $51 | 340% |
| Humana | $33 - $41 | 340% |
| Blue Cross Blue Shield | $46 | 474% |
| Aetna | $49 - $67 | 505% |
| Midlands Choice- All Plans | $49 - $60 | 505% |
| Medicaid / KanCare | $55 - $67 | 566% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Decatur Health in Oberlin, Kansas, the cash price is $54.00, which is slightly lower than the facility's negotiated rates of $49.00 to $67.00 across various insurance plans. While commercial insurance contracts often cap charges to protect members, these negotiated amounts can sometimes exceed the cash price, making self-pay a potentially more affordable option for patients with high deductibles. It is important to note that Medicaid/KanCare plans in this region have a negotiated range of $55.00 to $67.00, which is higher than the cash rate. Patients should verify their specific plan's allowed amount before scheduling, as assuming in-network coverage guarantees the lowest price is a common pitfall; in some cases, paying out-of-pocket upfront can result in significant savings compared to the insurance negotiated ceiling.
To ensure you are not overcharged, request a full itemized bill that lists every specific CPT code and unit cost, as summary bills often hide errors or unbundled charges. Since over 80% of hospital bills contain mistakes, such as double-billing or charges for services not rendered, asking for a line-by-line review is the most effective way to reduce medical debt. Additionally, if you receive a balance bill for out-of-network services at an in-network facility, remember that the No Surprises Act generally prohibits these surprise charges for emergency and non-emergency care. Finally, consider asking the hospital about prompt-pay discounts, which can reduce the total cost by 20% to 50% if you settle the bill in full within 30 days, bypassing the administrative costs associated with