CMS Price Transparency Data

Blood test, vitamin B12

Facility: Mc Donough District Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $92
  • Cash Discount Price: $59
  • vs. Medicare Baseline: 6.10x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Mc Donough District Hospital is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 6.10x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.
Cash / Self-Pay
$59

Average discount available for prompt cash payment at this facility.

Insurance Median
$92

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: $59 (391%)
Insurance Median: $92 (610%)
Cash: $59 (391% of Medicare)
Ins. Median: $92 (610% 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 610% of the Medicare baseline (a markup of 510%). 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
Health Alliance $9 - $100 60%
Aetna $13 - $112 86%
Blue Cross Blue Shield $13 - $112 86%
Humana $13 - $101 86%
Medicaid / KanCare $13 - $112 86%
Hfn $14 - $101 93%
UnitedHealthcare $14 - $101 93%
Medicare (plans) $15 99%
Meridian $15 99%
Molina $15 - $112 99%
Mutual Medical $15 - $112 99%
Tricare $15 99%
Veteran Affairs $15 99%
Springfield Health $92 610%
Consociate $95 630%
Trilogy $95 630%
Blue Choice $101 670%
Current Health $101 670%
Healthlink $101 - $105 670%
Preferred Plan $106 703%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals