Blood test, average blood sugar (A1c)
Facility: Golden Valley Memorial Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $10
- Cash Discount Price: $39
- vs. Medicare Baseline: 1.03x 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 |
|---|---|---|
| Aetna | $10 | 103% |
| Home State Health | $10 | 103% |
| Humana | $10 | 103% |
| UnitedHealthcare | $10 - $17 | 103% |
| Ambetter / Centene | $12 | 124% |
Consumer Guidance & Cost Commentary
For a blood test measuring average blood sugar (A1c), Golden Valley Memorial Hospital in Clinton, MO, lists a cash price of $39. This rate is significantly higher than the facility's own negotiated average of $10 and exceeds the national cash median of $39. It is important to note that while cash payments can sometimes be more cost-effective for patients with high-deductible plans if the insurance negotiated rate is lower, in this specific instance, the cash price matches the national average but remains double the facility's internal negotiated rate. Patients should verify if their specific insurance plan falls under the "self-pay" or "prompt-pay" categories, as hospitals often offer additional discounts for upfront payments to avoid administrative processing costs.
The facility's pricing structure also provides a clear benchmark against federal standards. The gross charge for this service is $65, while the Medicare amount is $9.71, indicating a markup of approximately 6.7 times the Medicare rate. This highlights the difference between the hospital's full chargemaster list and the actual cost baseline used by the government. If a patient receives this service through an out-of-network provider or encounters unexpected ancillary services, they may face balance billing for the difference between the allowed amount and the full charge, though the No Surprises Act provides protections for emergency care and non-emergency services at in-network facilities. To ensure accuracy, patients should request an itemized billing audit to review every line item and confirm that no unbundled codes or services not rendered are included in the final invoice.