Blood test, average blood sugar (A1c)
Facility: Fredonia Regional Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $41
- Cash Discount Price: $56
- vs. Medicare Baseline: 4.22x 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 422% of the Medicare baseline (a markup of 322%). 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 |
|---|---|---|
| UnitedHealthcare | $4 - $60 | 41% |
| Blue Cross Blue Shield | $22 - $36 | 227% |
| Veterans Programs - All Plans | $23 - $34 | 237% |
| Aetna | $23 - $60 | 237% |
| Meritain-All Plans | $40 - $60 | 412% |
| Cigna | $40 - $60 | 412% |
| Reserve National-All Plans | $40 - $60 | 412% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Fredonia Regional Hospital in Kansas, the cash price is $56.00, which matches the facility's negotiated rate of $41.00 and the state average. This test is billed under CPT code 83036, and while the facility is a Critical Access Hospital owned by the local government, the cash rate is notably higher than the Medicare benchmark of $9.71. Because commercial insurance plans often negotiate rates that can exceed cash prices, patients with high-deductible plans may find paying out-of-pocket for $56.00 is more cost-effective than relying on insurance, which could result in a higher allowed amount. To ensure you are getting the best price, it is advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if settled upfront.
When reviewing your bill, be sure to request a full itemized statement rather than accepting a summary invoice that obscures individual charges. Since over 80% of hospital bills contain errors, such as unbundled codes or services not rendered, a line-by-line audit is the most effective way to identify and correct mistakes before payment. Additionally, while the facility is in-network for several major payers including UnitedHealthcare and Aetna, remember that in-network status does not guarantee the lowest possible rate, as different insurers negotiate different ceilings. If you receive a balance bill for the difference between the provider's charge and your insurance allowed amount, you may be protected under the No Surprises Act, which bans surprise billing for emergency care and non-emergency services at in