Blood test, average blood sugar (A1c)
Facility: Clay County Medical Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $73
- Cash Discount Price: $78
- 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 |
|---|---|---|
| Wppa/Providrs Care- All Plans | $68 - $77 | 700% |
| Aetna | $68 - $77 | 700% |
| Multiplan- All Plans | $70 - $79 | 721% |
| Health Partners - All Plans | $70 - $79 | 721% |
| UnitedHealthcare | $70 - $79 | 721% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Clay County Medical Center in Clay Center, KS, the facility's cash median rate of $78.00 is identical to its gross charge and significantly higher than the state average of $70.00. While the facility is a Critical Access Hospital with government local ownership, patients should note that commercial insurance negotiated rates for this service range from $68.00 to $79.00 across five major payers, including Wppa/Providrs Care, Aetna, and UnitedHealthcare. Because these negotiated rates often exceed the cash price, individuals with high-deductible plans or those without insurance may find paying out-of-pocket cheaper than using insurance, provided they qualify for the facility's prompt-pay discounts.
To ensure you are not overcharged, it is critical to request an itemized billing audit before signing any consent waivers, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Although the No Surprises Act protects patients from balance billing for out-of-network emergency care at in-network facilities, unexpected ancillary charges can still occur if not carefully reviewed. Always verify your specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket costs than paying the cash rate directly.