Blood test, hemoglobin
Facility: Lmh
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $4
- Cash Discount Price: $19
- vs. Medicare Baseline: 1.69x 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 $2.37 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 |
|---|---|---|
| Medicare (plans) | $2 | 84% |
| Humana | $2 | 84% |
| Blue Cross Blue Shield | $2 - $53 | 84% |
| Allwell | $2 | 84% |
| Cigna | $2 - $55 | 84% |
| UnitedHealthcare | $2 - $46 | 84% |
| Haskell Indian Health Services | $2 | 84% |
| Aetna | $3 - $68 | 127% |
| Ambetter / Centene | $4 | 169% |
| Non Contracted | $59 - $66 | 2489% |
| First Health | $68 - $76 | 2869% |
Consumer Guidance & Cost Commentary
For this blood test for hemoglobin at Lmh in Lawrence, KS, the facility's cash price is $19.00, which is significantly lower than the state average of $78.00. While the facility is government-owned and holds a 4-star rating, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, the highest negotiated rate among in-network payers like Aetna and First Health can reach $68.00, whereas the cash price remains at $19.00. This dynamic suggests that for patients with high-deductible plans, paying the cash price directly may result in lower out-of-pocket costs compared to relying on insurance, provided the patient understands their deductible status before scheduling.
To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts from the hospital before check-in, as these programs can offer fee reductions of 20% to 50% by bypassing costly insurance claims processing. Additionally, since the facility is in-network, the No Surprises Act protects patients from balance billing for out-of-network services rendered at this location, though it is crucial to verify that all ancillary services, such as lab draws, are covered under the same network agreement. Finally, if a bill is received, patients should request a full itemized audit to identify any errors or unbundled charges, as over 80% of hospital bills contain mistakes that can be corrected through formal written disputes rather than verbal agreements.