Blood test, average blood sugar (A1c)
Facility: Girard Medical Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $49
- Cash Discount Price: $84
- vs. Medicare Baseline: 5.05x 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 505% of the Medicare baseline (a markup of 405%). 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 | $36 - $49 | 371% |
| UnitedHealthcare | $49 - $133 | 505% |
| Humana | $49 | 505% |
| Medicare (plans) | $49 | 505% |
| Kansas Superior Select-All Plans | $49 | 505% |
| Ambetter / Centene | $49 | 505% |
| Aetna | $49 - $245 | 505% |
| Multiplan-All Plans | $130 | 1339% |
| Uhhis-All Plans | $133 | 1370% |
Consumer Guidance & Cost Commentary
For this blood sugar test at Girard Medical Center, the cash median price of $84.00 is significantly lower than the negotiated rates paid by major insurers like UnitedHealthcare ($49–$133) and Aetna ($49–$245). While the facility's cash price is higher than its own negotiated average of $49.00, it remains well below the gross chargemaster of $140.00. For patients with high-deductible plans, paying the cash price directly may result in lower out-of-pocket costs compared to insurance, as the negotiated rates often exceed the cash amount. However, patients should verify their specific plan's deductible status before assuming insurance will be cheaper, as many plans require the deductible to be met before coverage applies.
To ensure you receive the most accurate billing, always request an itemized bill that lists specific CPT codes rather than accepting a summary invoice that obscures individual charges. This is crucial because over 80% of hospital bills contain errors, such as unbundled services or charges for items never rendered, which can lead to unexpected debt. Additionally, under the No Surprises Act, you are protected from balance billing for out-of-network services at in-network facilities, meaning you should not sign away your rights to dispute surprise bills. If you choose to pay cash, ask the facility about prompt-pay discounts, which can reduce the $84.00 median price by 20% to 50% if paid upfront, bypassing the administrative costs associated with insurance claims.