Blood test, average blood sugar (A1c)
Facility: Lincoln County Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $36
- Cash Discount Price: $88
- vs. Medicare Baseline: 3.71x 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 371% of the Medicare baseline (a markup of 271%). 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 | 371% |
Consumer Guidance & Cost Commentary
For this blood sugar test (CPT 83036) at Lincoln County Hospital in Lincoln, KS, the cash price of $88.00 is significantly lower than the facility's gross charge of $98.00. While the hospital is a Critical Access Hospital owned by the local government, the cash rate is notably higher than the state average of $36.00. However, for patients with high-deductible plans, paying the cash price of $88.00 upfront may be more cost-effective than using insurance, as the negotiated rate for Blue Cross Blue Shield is also $36.00, which could result in higher out-of-pocket costs if the patient's deductible has not yet been met.
To minimize costs, patients should verify their specific plan's deductible status before scheduling, as using insurance might lead to balance billing if the provider is out-of-network for this specific service. Although the No Surprises Act protects against balance billing for emergency care and non-emergency services at in-network facilities, it is crucial to request a self-pay or prompt-pay discount before check-in to avoid automatic claims submission. If you choose to pay out-of-network, ensure you receive a full itemized bill to audit for errors, as over 80% of hospital bills contain mistakes that can be corrected through a formal written dispute sent to the billing supervisor.