Blood test, average blood sugar (A1c)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $45
- Cash Discount Price: $80
- vs. Medicare Baseline: 4.63x 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 463% of the Medicare baseline (a markup of 363%). 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 |
|---|---|---|
| Aetna | $36 - $61 | 371% |
| Blue Cross Blue Shield | $36 | 371% |
| UnitedHealthcare | $45 - $46 | 463% |
Consumer Guidance & Cost Commentary
For the CPT code 83036, representing an average blood sugar (A1c) test, Community Memorial Healthcare, Inc. in Marysville, KS, lists a cash median price of $80.00 and a median negotiated rate of $45.00. While the facility's cash price matches the gross charge of $80.00, patients with high-deductible plans may find paying out-of-pocket cheaper than using insurance, as the negotiated rate of $45.00 is significantly lower than the cash price. It is important to note that commercial insurance rates often include administrative overhead and contract dynamics that can inflate the baseline price beyond the actual cost of care.
This specific service is priced at 4.6 times the Medicare amount of $9.71, which serves as a scientifically validated benchmark for the true cost of delivery. Although the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that balance billing can occur if services are rendered by out-of-network providers, even at an in-network facility. To avoid unexpected costs, consumers should request a full itemized bill to verify all charges and inquire about prompt-pay discounts, which can reduce the total amount due by 20% to 50% if paid in full upfront.