Blood test, average blood sugar (A1c)
Facility: Mitchell County Hospital Health Systems
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $78
- Cash Discount Price: $74
- vs. Medicare Baseline: 8.03x 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 803% of the Medicare baseline (a markup of 703%). 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 | $10 - $82 | 103% |
| Blue Cross Blue Shield | $36 | 371% |
| Triwest Well Mark All Plans | $70 | 721% |
| First Health-All Plans | $74 | 762% |
| Aetna | $74 | 762% |
| Pref Hlth Care Sytms Comm - All Plans | $74 | 762% |
| Phc Leased Ntwrk Access - All Plans | $78 | 803% |
| Multiplan Ppo - All Plans | $78 | 803% |
| Auxiant-All Plans | $78 | 803% |
| Cigna | $81 | 834% |
| Health Partners Ks-All Plans | $81 | 834% |
Consumer Guidance & Cost Commentary
For the CPT code 83036, representing an average blood sugar (A1c) test, the gross charge at Mitchell County Hospital Health Systems is $82.00. While the facility's cash median rate is $74.00, which is lower than the gross charge, the negotiated rates for in-network insurance plans range from $36.00 to $82.00, with most major payers settling at $74.00 or higher. It is important to note that cash payments can sometimes be more cost-effective than using insurance, particularly for patients with high-deductible plans where the insurance negotiated rate exceeds the cash price. Patients should verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final amount owed.
The facility's pricing structure should be evaluated against the Medicare benchmark, which stands at $9.71 for this service. The commercial negotiated rates observed in this dataset average significantly higher than the Medicare rate, reflecting the administrative costs and contract dynamics inherent in commercial insurance billing. Because over 80% of hospital bills contain errors, patients should request a detailed, itemized statement rather than accepting a summary bill, which may obscure unbundled charges or services not rendered. If a balance bill arises from an out-of-network ancillary service, such as a specific lab test, the No Surprises Act may provide federal protections against unexpected costs, and patients should be prepared to dispute any surprise charges in writing rather than paying immediately out of fear.