CMS Price Transparency Data

Blood test, vitamin B12

Facility: Mt Sinai Hospital Medical Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $49
  • Cash Discount Price: $140
  • vs. Medicare Baseline: 3.25x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Mt Sinai Hospital Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 3.25x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$140

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $140 (928%)
Insurance Median: $49 (325%)
Cash: $140 (928% of Medicare)
Ins. Median: $49 (325% 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 325% of the Medicare baseline (a markup of 225%). 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
Blue Cross Blue Shield $14 - $202 93%
Cigna $14 - $392 93%
Advocate Physician Prtnrs Mcr $15 99%
Cenpatico Illinicare Dual $15 99%
Cenpatico Illinicare Mcr - All Other Plans $15 99%
Humana $15 - $996 99%
Lawndale Christian - All Plans $15 - $63 99%
Meridian/Harmony D-Snp - All Plans $15 99%
Nextlevel Hlth Icp Fhp Aca - All Plans $15 99%
Tricare $15 99%
UnitedHealthcare $15 99%
Va Healthnet - All Plans $15 99%
Harmony Behavioral Htlh - All Plans $16 106%
Molina Mcr - All Other Plans $16 106%
Zing Mcr Adv - All Plans $16 106%
Advocate Physician Prtnrs - All Other Plans $17 113%
Ambetter / Centene $17 - $333 113%
Aetna $18 - $717 119%
Family Health Network Mcaid - All Plans $18 119%
Molina Mcaid $19 126%
Partners In Hlth - All Plans $33 - $127 219%
Healthlink Hmo $42 - $159 279%
Healthlink Ppo - All Other Plans $42 - $159 279%
Oscar - All Plans $48 - $92 318%
Compsych Ip/Op Only - All Plans $50 - $190 332%
Hfn Platinum $54 - $206 358%
Multiplan Primary Ntwrk/Phcs - All Other Plans $58 - $222 385%
Hfn Epo $67 - $254 444%
Multiplan Complementary Ntwrk $67 - $254 444%
Hfn Ppo - All Other Plans $73 - $279 484%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals