Blood test, average blood sugar (A1c)
Facility: Children'S Mercy South
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $71
- Cash Discount Price: $56
- vs. Medicare Baseline: 7.31x 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 731% of the Medicare baseline (a markup of 631%). 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 |
|---|---|---|
| Cigna | $5 - $79 | 51% |
| UnitedHealthcare | $9 - $77 | 93% |
| Wppa Providrs Care | $10 - $74 | 103% |
| Healthy Blue | $11 - $27 | 113% |
| Medicaid / KanCare | $11 | 113% |
| Blue Cross Blue Shield | $16 - $84 | 165% |
| Home State Health | $23 | 237% |
| Centivo | $60 - $74 | 618% |
| Medica | $66 - $71 | 680% |
| Aetna | $68 - $78 | 700% |
| Orscheln | $74 | 762% |
| Health Midwest Comprehensive Care | $74 | 762% |
| Nebraska Furniture Mart | $74 | 762% |
| Quiktrip | $74 | 762% |
| Wellfit/Centrus | $74 | 762% |
| Humana | $76 | 783% |
| Coventry Health Care Of Kansas | $84 | 865% |
| Coxhealth Network | $84 - $90 | 865% |
| Mercy Health | $86 - $88 | 886% |
| Multiplan | $87 | 896% |
| American Healthcare Alliance | $97 | 999% |
| Healthlink | $100 | 1030% |
| National Preferred Provider Network | $103 - $106 | 1061% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Children's Mercy South in Overland Park, the cash price of $56.00 is significantly lower than the facility's negotiated rates with major insurers like Cigna and UnitedHealthcare, which range from $5 to $79. While commercial insurance contracts often result in higher allowed amounts due to administrative overhead and network tiering, paying cash upfront can be the most cost-effective option for patients with high-deductible plans who have not yet met their coverage threshold. To secure the lowest possible price, patients should explicitly request self-pay or prompt-pay discounts before scheduling, as these upfront fee reductions can bypass the costly insurance claims process and administrative markups that inflate commercial rates.
The facility's cash rate of $56.00 is also notably lower than the Medicare benchmark of $9.71 adjusted for local costs, indicating a substantial markup on the commercial side. Since Medicare rates represent a scientifically validated baseline for the true cost of care, comparing against the facility's gross charge of $118.00 reveals that the negotiated rates are far from the "fair price" typically defined as 120% to 150% of Medicare. Consumers should avoid relying on summary bills that obscure individual line items and instead demand a detailed itemized statement to identify any unbundled codes or services not rendered. If a balance bill arises from an out-of-network ancillary service, patients are protected under the No Surprises Act and should dispute the charge with their insurer rather than paying immediately out of fear.