CMS Price Transparency Data

Blood test, vitamin B12

Facility: Spencer Municipal Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $127
  • Cash Discount Price: $112
  • vs. Medicare Baseline: 8.42x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Spencer Municipal Hospital is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 8.42x the Medicare baseline. Located in 1200 1St Avenue East, Spencer, IA.
Cash / Self-Pay
$112

Average discount available for prompt cash payment at this facility.

Insurance Median
$127

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$15.08

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $15.08 (100%)
Cash / Self-Pay: $112 (743%)
Insurance Median: $127 (842%)
Cash: $112 (743% of Medicare)
Ins. Median: $127 (842% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $15.08 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 842% of the Medicare baseline (a markup of 742%). 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.

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
Medicaid / KanCare $14 93%
Humana $15 - $141 99%
Medicare (plans) $15 99%
UnitedHealthcare $15 - $134 99%
Wellmark Hmo $50 332%
Wellmark Ppo $54 358%
Healthpartners (All) $119 789%
Midlands Choice - Ilcc $126 836%
Midlands Choice - Morton Bldg $126 836%
Coventry - Commercial Hmo $134 889%
Avera Health Plan $141 935%
Coventry - Commercial Ppo $141 935%
First Choice Of Midwest $141 935%
Midlands Choice (All Others) $141 935%
Sanford Health $141 935%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 1St Avenue East, Spencer, IA 51301
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals