CMS Price Transparency Data

Blood test, vitamin B12

Facility: Sanford Sheldon Medical Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $97
  • Cash Discount Price: $121
  • vs. Medicare Baseline: 6.43x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Sanford Sheldon Medical Center is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 6.43x the Medicare baseline. Located in 118 North Seventh Avenue, Po Box 250, Sheldon, IA.
Cash / Self-Pay
$121

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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: $121 (802%)
Insurance Median: $97 (643%)
Cash: $121 (802% of Medicare)
Ins. Median: $97 (643% 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 643% of the Medicare baseline (a markup of 543%). 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
Sanford Health Plan Align $43 285%
Ucare $46 - $133 305%
Aetna $47 - $131 312%
Blue Cross Blue Shield $47 312%
Health Partners $47 - $113 312%
Medicare (plans) $47 312%
UnitedHealthcare $47 - $126 312%
Primewest $48 318%
Wellmark $76 - $79 504%
Sanford Health Plan $81 - $95 537%
Security Health Plan $83 550%
Medica $125 - $133 829%
First Choice Health Network $136 902%
Healthez $136 902%
Multiplan $136 902%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 118 North Seventh Avenue, Po Box 250, Sheldon, IA 51201
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals