Blood test, average blood sugar (A1c)
Facility: William Newton Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $17
- Cash Discount Price: $48
- vs. Medicare Baseline: 1.75x 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.
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 |
|---|---|---|
| Ambetter / Centene | $2 - $60 | 21% |
| Blue Cross Blue Shield | $2 - $34 | 21% |
| UnitedHealthcare | $2 - $54 | 21% |
| Triwest- All Plans | $2 - $21 | 21% |
| Providrs Care Nexus | $3 - $37 | 31% |
| Providrs Care - All Other Plans | $4 - $42 | 41% |
Consumer Guidance & Cost Commentary
For the CPT code 83036, representing an average blood sugar (A1c) test, the cash median price at William Newton Hospital in Winfield, KS, is $48.00. This cash rate is significantly higher than the Medicare benchmark of $9.71, which serves as the federal government's fixed reimbursement baseline for this service. While commercial insurance plans like Ambetter / Centene and Blue Cross Blue Shield negotiate rates ranging from $2 to $60 and $2 to $34 respectively, these negotiated amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the $48.00 cash rate directly, as this avoids the potential for higher negotiated fees that insurance carriers charge when deductibles have not yet been met.
To secure the lowest possible cost, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling the test, as hospitals frequently offer fee reductions for upfront payments that bypass insurance billing cycles. It is important to note that while the facility is a Critical Access Hospital with a government-local ownership structure, the gross charge of $48.00 represents the starting point before any discounts are applied. Consumers should avoid relying on summary bills and instead request a detailed, itemized statement to ensure no errors or unbundled charges are included. Finally, while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, patients must verify their specific plan details and deductible status to fully understand their financial responsibility.