Blood test, average blood sugar (A1c)
Facility: St Luke Hospital & Living Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $54
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 5.56x 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 556% of the Medicare baseline (a markup of 456%). 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 |
|---|---|---|
| Humana | $54 | 556% |
| Bluestem Pace | $54 | 556% |
| Kansas Department Of Health And Environment | $54 | 556% |
| Blue Cross Blue Shield | $54 | 556% |
| UnitedHealthcare | $54 | 556% |
| Ambetter / Centene | $54 | 556% |
| Va Ccn | $54 | 556% |
Consumer Guidance & Cost Commentary
For the CPT code 83036, representing an average blood sugar (A1c) test, the facility in Marion, KS, has a negotiated rate of $54.00, which aligns exactly with the lowest and highest negotiated amounts reported across all seven payers. This rate is significantly higher than the Medicare benchmark of $9.71, reflecting a markup typical of commercial contracts. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should note that cash-pay options are not listed in this report. However, if a patient has a high-deductible plan where the insurance negotiated rate exceeds the cash price, paying out-of-pocket could sometimes result in lower out-of-pocket costs, provided they secure a "self-pay" or "prompt-pay" discount before scheduling.
It is important to distinguish between the facility's gross charge of $105.00 and the actual amounts paid by insurers. The gross charge serves as a baseline for billing but is not the price you will pay; the $54.00 negotiated rate is the ceiling amount insurance plans are contractually allowed to pay. Since this specific code does not have a reported cash median or state/county average in the provided data, direct comparisons to regional averages are not available. To ensure you are receiving the best possible price, we recommend requesting a formal itemized billing audit to verify that no unbundled codes or services not rendered have inflated the final charge, and always confirming with the hospital's billing department regarding any available prompt-pay discounts prior to your visit.