Blood test, average blood sugar (A1c)
Facility: Hodgeman County Health Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $73
- Cash Discount Price: $83
- vs. Medicare Baseline: 7.52x 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 752% of the Medicare baseline (a markup of 652%). 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 | $34 - $36 | 350% |
| Humana | $67 | 690% |
| Triwest - All Plans | $67 | 690% |
| Medicaid / KanCare | $67 - $104 | 690% |
| UnitedHealthcare | $67 - $99 | 690% |
| Aetna | $83 | 855% |
| First Health - All Plans | $94 | 968% |
| Health Partners - All Plans | $99 | 1020% |
| Wppa (Provdrscare) - All Plans | $99 | 1020% |
Consumer Guidance & Cost Commentary
For this blood sugar test (CPT 83036) at Hodgeman County Health Center in Jetmore, KS, the cash price is $83.00, which is lower than the facility's negotiated rates with major payers like UnitedHealthcare ($99–$99) and Aetna ($83–$83). While the cash rate aligns with the lowest end of the negotiated spectrum, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allowed amount exceeds the cash price. It is important to note that the facility's cash rate is significantly higher than the national Medicare benchmark of $9.71, reflecting the true cost of care before commercial markups. Additionally, the cash price is notably higher than the state average for this procedure, which is $73.00, suggesting that local market dynamics or facility-specific costs influence pricing in this Critical Access Hospital.
Patients should be aware that insurance companies often pay less than the negotiated rate due to deductibles and co-insurance, meaning the final bill could still be substantial. If you choose to pay directly, ask the billing department about "prompt-pay" discounts, which can reduce the $83.00 cash price by an additional 20% to 50% for upfront payment. Furthermore, if you receive a bill from an out-of-network provider or a service like emergency care, the No Surprises Act may protect you from balance billing, but you should dispute any unexpected charges in writing rather than paying immediately. Always request a full, itemized bill before signing any consent forms or making payments to ensure no errors, unbundled codes, or services not rendered are included