CMS Price Transparency Data

Blood test, potassium

Facility: Lmh

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $5
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Lmh is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 1.05x the Medicare baseline. Located in 325 Maine Street, Lawrence, KS.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$5

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.76 (100%)
Cash / Self-Pay: $30 (630%)
Insurance Median: $5 (105%)
Cash: $30 (630% of Medicare)
Ins. Median: $5 (105% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.76 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $4 - $46 84%
Blue Cross Blue Shield $4 - $78 84%
Humana $5 105%
Allwell $5 105%
Aetna $5 - $100 105%
Haskell Indian Health Services $5 105%
Cigna $5 - $80 105%
Medicare (plans) $5 105%
Ambetter / Centene $7 147%
Non Contracted $96 2017%
First Health $112 2353%

Consumer Guidance & Cost Commentary

For this blood test, the cash price of $30.00 is significantly lower than the facility's negotiated rates, which range from $4 to $112 depending on the insurance plan. While the facility's cash rate is competitive, it is important to note that commercial insurance often pays negotiated rates that exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. The facility, Lmh in Lawrence, KS, is a government-owned acute care hospital, and while the cash rate is well below the facility's gross charge of $120.00, patients should verify their specific plan's allowed amount before scheduling.

To ensure you are not overcharged, always request an itemized bill before paying, as summary bills can hide errors or unbundled charges. If you receive a balance bill from an out-of-network provider, remember that the No Surprises Act protects you from paying the difference between the provider's rate and your insurance's allowed amount for emergency care and non-emergency services at in-network facilities. Additionally, ask the billing department about prompt-pay discounts, which can reduce your cash bill by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims processing.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 325 Maine Street, Lawrence, KS 66044
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals