Blood test, average blood sugar (A1c)
Facility: Aurora Medical Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $34
- Cash Discount Price: $55
- vs. Medicare Baseline: 3.50x 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 350% of the Medicare baseline (a markup of 250%). 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 |
|---|---|---|
| UnitedHealthcare | $8 - $139 | 82% |
| Aurora Caregiver | $10 | 103% |
| Blue Cross Blue Shield | $10 - $140 | 103% |
| Common Ground | $20 - $21 | 206% |
| Centivo | $21 | 216% |
| Aetna | $22 - $136 | 227% |
| Health Payment Systems | $24 | 247% |
| Quartz One | $24 | 247% |
| Healthpartners | $26 - $124 | 268% |
| Hs Technology | $27 | 278% |
| Molina Exchange | $27 | 278% |
| Quartz Group | $28 | 288% |
| Cigna | $29 - $140 | 299% |
| Everpointe Elite | $29 | 299% |
| Wisconsin Physician Service | $31 - $33 | 319% |
| Health Eos Plus | $33 - $99 | 340% |
| Trilogy | $34 | 350% |
| Health Eos | $44 - $132 | 453% |
Consumer Guidance & Cost Commentary
For patients paying cash, the most important fact to know immediately is that the cash rate for this blood test procedure is $55, which is significantly lower than the facility's gross charge of $110. If you have a high-deductible plan or have met your deductible, paying this $55 upfront could be more cost-effective than using insurance, as some commercial negotiated rates for this service can exceed $139. While the facility is a voluntary non-profit private hospital in Grafton, Wisconsin, with a 5-star rating, patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling to ensure they receive the lowest possible cash price and avoid unnecessary administrative fees.
The broader pricing context shows that the $55 cash rate is substantially lower than the facility's gross charge, but it is important to compare this against state and county averages to understand market positioning. While the facility's gross rate is $110, the median negotiated rate for in-network insurance is $34, and the Medicare amount for this procedure is $9.71. Because Medicare rates represent the federal government's baseline for the true cost of care, commercial rates are often marked up significantly above this benchmark. To avoid balance billing, patients should verify their network status and request an itemized bill to ensure no unexpected charges are applied, especially since federal protections under the No Surprises Act may limit out-of-network billing at in-network facilities.