Blood test, average blood sugar (A1c)
Facility: Memorial Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $62
- Cash Discount Price: $128
- vs. Medicare Baseline: 6.39x 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 639% of the Medicare baseline (a markup of 539%). 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 |
|---|---|---|
| Tricare | $10 - $62 | 103% |
| Ambetter / Centene | $11 - $68 | 113% |
| Blue Cross Blue Shield | $25 | 257% |
| Medicare (plans) | $62 | 639% |
| Humana | $62 | 639% |
| Coventry - All Other Plans | $111 | 1143% |
| Preferred Healthcare-All Plans | $117 | 1205% |
| Health Partners Of Kansas - All Plans | $117 | 1205% |
| Wppa/Providers Care-All Plans | $172 | 1771% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Memorial Hospital in Abilene, KS, the cash price is $128.00, which matches the facility's negotiated rate of $62.00 for most major payers like Tricare and Ambetter. While the facility is a Critical Access Hospital with a government ownership structure, it is important to note that commercial negotiated rates often include administrative overhead and can sometimes exceed the cash price for patients with high-deductible plans. In this specific case, the cash rate is significantly higher than the median negotiated amount, suggesting that paying out-of-pocket may not be the most cost-effective option if you have insurance coverage. However, patients should always verify their specific plan details, as some policies may cover the full $128.00 cash rate, while others might only cover the lower negotiated amount of $62.00.
When evaluating the cost against national standards, the Medicare benchmark for this service is $9.71, which serves as the objective baseline for fair pricing. The facility's cash rate of $128.00 represents a substantial markup compared to this federal standard, illustrating the difference between the true cost of care and the chargemaster list price. To potentially lower your out-of-pocket expenses, you should 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. Additionally, since over 80% of hospital bills contain errors, requesting a detailed, itemized statement before payment is a critical step to ensure you are not being charged for services not rendered or unbundled components.