CMS Price Transparency Data

Blood test, vitamin B12

Facility: Decatur Memorial Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $171
Cash Discount Price: $370
vs. Medicare Baseline: 11.34x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Decatur Memorial Hospital is $171. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $370. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 11.34x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.

Cash / Self-Pay

$370

Average discount available for prompt cash payment at this facility.

Insurance Median

$171

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: $370 (2454%)

Insurance Median: $171 (1134%)

Cash: $370 (2454% of Medicare)

Ins. Median: $171 (1134% 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 1134% of the Medicare baseline (a markup of 1034%). 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
Medicaid / KanCare	$13 - $14	86%
Blue Cross Blue Shield	$14 - $370	93%
Aetna	$15 - $248	99%
Coventry	$15 - $188	99%
Health Alliance	$15 - $246	99%
Humana	$15 - $240	99%
Medicare (plans)	$15	99%
Tricare	$15	99%
UnitedHealthcare	$15 - $370	99%
Veterans Administration	$15	99%
Wellcare	$15	99%
Caterpillar	$19	126%
Plain Church Medical Group	$20 - $166	133%
Illinois Workers Compensation	$73 - $104	484%
Hfn	$98 - $278	650%
Commercial Workers Compensation	$99	656%
Mennonite Churches	$130	862%
Health Alliance Mh Employee Plan	$170	1127%
Cigna	$172	1141%
6 Degrees Health	$222	1472%
Hopetrust	$222	1472%
Hst	$222	1472%
Phcs Savility	$240	1592%
Phcs Multiplan Ppo	$252	1671%
Healthlink	$254	1684%
Corvel	$266	1764%
Consociate	$274	1817%
Liability	$370	2454%

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 $370.
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 Decatur Memorial 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.