Blood test, average blood sugar (A1c)
Facility: Phillips County Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $51
- Cash Discount Price: $48
- vs. Medicare Baseline: 5.25x 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 525% of the Medicare baseline (a markup of 425%). 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 | $36 - $45 | 371% |
| UnitedHealthcare | $45 - $56 | 463% |
| Health Partners-All Plans | $56 | 577% |
| Medicaid / KanCare | $56 | 577% |
Consumer Guidance & Cost Commentary
For this blood sugar test at Phillips County Hospital in Phillipsburg, KS, the facility's negotiated rates range from $36 to $56 depending on your specific insurance plan, with a median allowed amount of $45.00. While the facility is a Critical Access Hospital owned by the local government, its pricing structure aligns closely with regional standards; the cash price of $48.00 is only slightly higher than the median negotiated rate, and the facility's overall pricing performance is within 5.3% of the Medicare benchmark. Because commercial insurance contracts often include administrative overhead that inflates the baseline price, patients with high-deductible plans may find that paying the cash price of $48.00 upfront is more cost-effective than relying on insurance, which could result in a higher out-of-pocket expense if the deductible has not yet been met.
To ensure you receive the best possible rate, it is important to verify your specific plan's negotiated tier before scheduling, as in-network status does not guarantee the lowest possible price. If you choose to pay directly, ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% for upfront payment and bypass costly claims processing fees. Additionally, if you receive a bill after using insurance, request a full itemized statement to review every line item for errors or unbundled charges, as over 80% of hospital bills contain inaccuracies that can be corrected. Finally, remember that under the No Surprises Act, you are protected from balance billing for out-of-network services at this in-network facility, so you should not feel pressured to pay unexpected differences without first disputing