83605

Lactic acid level

Medicare pricing data for 1,016 providers across 43 states

🤖AI Overview

This procedure has a 5.3x markup — hospitals charge $60.27 but Medicare allows only $11.30. Uninsured patients may face bills 5.3 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Lactic acid level (HCPCS code 83605) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.30, but hospitals typically charge $60.27 — a 5.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.26

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.30, your out-of-pocket cost would be approximately $2.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.30
Average Hospital Charge
$60.27
Markup Ratio
5.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$60.27
Medicare Allowed$11.30
Medicare Payment$11.30

Hospitals charge 5.3x more than what Medicare allows for this procedure. Medicare actually pays $11.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Arizona$11$15443542+0.4%
Florida$11$73691,365+0.4%
Georgia$11$9314391+0.4%
Hawaii$11$373174+0.4%
Idaho$11$311033+0.4%
Indiana$11$222762+0.4%
Kansas$11$1037361+0.4%
Michigan$11$311343+0.4%
Minnesota$11$60101518+0.4%
Mississippi$11$30518+0.4%
Missouri$11$45436+0.4%
Montana$11$42852+0.4%
North Carolina$11$40165,986+0.4%
North Dakota$11$71524+0.4%
Ohio$11$7916604+0.4%
Oklahoma$11$6212274+0.4%
Oregon$11$4021117+0.4%
Rhode Island$11$31211+0.4%
South Carolina$11$401116+0.4%
South Dakota$11$64756+0.4%
Tennessee$11$4724264+0.4%
Virginia$11$4948512+0.4%
Wyoming$11$721470+0.4%
Puerto Rico$11$12714+0.4%
Alaska$11$78513+0.4%
Maryland$11$3311794+0.3%
Massachusetts$11$10212169+0.3%
New Jersey$11$113311,101+0.3%
New York$11$44742,025+0.3%
Alabama$11$8413143+0.3%
Pennsylvania$11$10013466+0.2%
Illinois$11$6857299+0.1%
Nevada$11$366291+0.1%
Texas$11$70821,2620.0%
California$11$56673,319-0.2%
Kentucky$11$537133-1.0%
Wisconsin$11$8428327-1.0%
Utah$11$40627-1.4%
Iowa$11$63441-1.6%
Colorado$11$4552238-1.9%
New Mexico$11$58652-5.2%
Washington$11$5547451-5.8%
Arkansas$8$17838-30.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber