Blood test, average blood sugar (A1c)
Facility: Susan B Allen Memorial Hospital
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $554
- Cash Discount Price: $44
- vs. Medicare Baseline: 57.05x 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 5705% of the Medicare baseline (a markup of 5605%). 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 | $350 | 3605% |
| Providrs Care | $757 | 7796% |
Consumer Guidance & Cost Commentary
For the blood sugar (A1c) test at Susan B Allen Memorial Hospital in El Dorado, KS, the facility's cash median price is $44.00, which is significantly lower than the state average of $554.00. While the hospital's negotiated rates for UnitedHealthcare and Providrs Care are $350 and $757 respectively, these figures represent the maximum amounts insurers agree to pay under contract, not the final cost to you. If you have a high-deductible plan or have not yet met your deductible, paying the $44.00 cash price upfront could save you money compared to the negotiated rates your insurance would process, as commercial contracts often include administrative overhead that inflates the baseline price.
Before scheduling this service, it is crucial to verify your specific plan's allowed amount and check for "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid in full. Although the facility is a voluntary non-profit acute care hospital, patients should avoid assuming that being in-network guarantees the lowest possible price, as different insurers negotiate different rates. To ensure you are not overcharged, request a full itemized bill listing the specific CPT code 83036 and review it against the Medicare benchmark of $9.71, which serves as the objective baseline for fair pricing. If you receive a large bill after insurance submission, dispute any balance billing immediately and ask for a formal audit to identify errors or unbundled charges before payment.