Blood test, average blood sugar (A1c)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $48
- Cash Discount Price: $48
- vs. Medicare Baseline: 4.94x 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 494% of the Medicare baseline (a markup of 394%). 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 |
|---|---|---|
| Va Ccn - All Plans | $5 | 51% |
| Humana | $27 | 278% |
| Tricare | $30 | 309% |
| UnitedHealthcare | $35 - $56 | 360% |
| Medicaid / KanCare | $35 - $56 | 360% |
| Aetna | $35 - $50 | 360% |
| Ambetter / Centene | $38 | 391% |
| Blue Cross Blue Shield | $49 | 505% |
| Health Partners - All Plans | $53 | 546% |
| Healthy Blue Mcaid - All Plans | $56 | 577% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Trego County Lemke Memorial Hospital, the cash median price is $48.00, which is higher than the state of Kansas average of $48.00 and the county average of $48.00. While commercial insurance plans like UnitedHealthcare, Medicaid/KanCare, and Aetna negotiate rates ranging from $35.00 to $56.00, patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance allowed amount exceeds $48.00. It is important to verify your specific plan's allowed amount before scheduling, as assuming that being in-network guarantees the lowest price can lead to unexpected costs if the negotiated rate is higher than the cash option.
This facility, a Critical Access Hospital in Wakeeney, KS, has a Medicare benchmark rate of $9.71, which serves as the objective baseline for evaluating pricing markups. The facility's cash rate of $48.00 represents a significant markup over the Medicare amount, illustrating the difference between federal cost-based reimbursement and commercial pricing. To ensure you are not overpaying, you should request an itemized billing audit to review the specific CPT code 83036 and confirm there are no unbundled charges or errors, as over 80% of hospital bills contain mistakes. Additionally, ask the billing department about prompt-pay discounts, which can reduce the final cash balance by 20% to 50% if paid upfront, bypassing the administrative overhead associated with insurance claims processing.