CMS Price Transparency Data

Blood test, vitamin B12

Facility: Monroe County Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $107
Cash Discount Price: $130
vs. Medicare Baseline: 7.10x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Monroe County Hospital is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 7.10x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$130

Average discount available for prompt cash payment at this facility.

Insurance Median

$107

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: $130 (862%)

Insurance Median: $107 (710%)

Cash: $130 (862% of Medicare)

Ins. Median: $107 (710% 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 710% of the Medicare baseline (a markup of 610%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Wellmark Hmo	$16	106%
Wellmark Ppo - All Other Plans	$17	113%
Va Ccn - All Plans	$33	219%
Mahp Mcare - All Plans	$91	603%
Tricare	$91	603%
UnitedHealthcare	$91 - $206	603%
Amerigroup Mcare	$92	610%
Humana	$92	610%
Wellmark Mcare	$92	610%
Aetna	$93 - $204	617%
Iowa Total Care Mcaid - All Plans	$108	716%
Molina Mcaid - All Plans	$110	729%
Amerigroup Mcaid - All Other Plans	$112	743%
Centivo - All Plans	$137	908%
Midlands Choice - All Plans	$152	1008%
Preferred Hlth - All Plans	$163	1081%
Geha - All Plans	$174	1154%
Multiplan - All Plans	$195	1293%
Integrated Hp - All Plans	$210	1393%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $130.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82607.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Monroe County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82607.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.