Blood test, average blood sugar (A1c)
Facility: Smith County Memorial Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $51
- Cash Discount Price: $55
- vs. Medicare Baseline: 5.25x 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 525% of the Medicare baseline (a markup of 425%). 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 | 371% |
| Medicaid / KanCare | $38 - $55 | 391% |
| Multiplan-All Plans | $49 - $50 | 505% |
| Health Partners Of Ks Ppo-All Plans | $51 - $52 | 525% |
| UnitedHealthcare | $51 - $52 | 525% |
| Midlands Choice-All Plans | $51 - $52 | 525% |
| Wppa-All Plans | $51 - $52 | 525% |
Consumer Guidance & Cost Commentary
For the CPT code 83036, representing an average blood sugar (A1c) test, Smith County Memorial Hospital in Smith Center, KS, lists a cash median price of $55.00, which matches the facility's gross charge. This cash rate is significantly higher than the Medicare benchmark of $9.71, reflecting a markup typical of commercial pricing structures where negotiated rates often average between 200% and 300% of the federal baseline. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find the cash price more affordable than the negotiated rates of $49.00 to $55.00 charged by various payers, as insurance billing includes administrative overhead that can inflate the final cost.
The median amount paid by insurers for this service ranges from $36.00 to $55.00 depending on the specific plan, with Medicaid/KanCare plans showing the lowest range at $38.00 to $55.00. To minimize out-of-pocket expenses, patients should verify their deductible status before scheduling, as paying the full negotiated rate without meeting the deductible can result in higher costs than paying cash. Additionally, patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims processing.