CMS Price Transparency Data

Blood test, vitamin B12

Facility: HSHS St Elizabeth's Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $106
  • Cash Discount Price: $96
  • vs. Medicare Baseline: 7.03x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at HSHS St Elizabeth's Hospital is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 7.03x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$96

Average discount available for prompt cash payment at this facility.

Insurance Median
$106

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: $96 (637%)
Insurance Median: $106 (703%)
Cash: $96 (637% of Medicare)
Ins. Median: $106 (703% 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 703% of the Medicare baseline (a markup of 603%). 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
Meridian Health Plan $10 66%
Molina Healthcare $10 - $16 66%
Aetna $15 - $94 99%
Blue Cross Blue Shield $15 - $133 99%
Clear Spring Health Of Illinois $15 99%
Health Alliance Medical Plans $15 - $113 99%
Health Partners $15 99%
Humana $15 99%
Sae Hospice $15 99%
UnitedHealthcare $15 - $133 99%
Celtic Insurance Company $32 212%
Naphcare $34 225%
Amish Community $37 245%
Claim Doc $38 252%
Hopetrust $38 252%
Wellfirst $86 570%
First Health $99 656%
Cigna $105 - $133 696%
Healthlink $106 - $133 703%
Caterpillar, Inc. $107 710%
Consociate Group $117 776%
Choicecare $120 796%
Healthcare Finest Network (Hfn) $120 796%
Multiplan/Phcs $120 796%
Provider Network Of America $120 796%
City Of Springfield $133 882%
Current Health Solutions $133 882%
Healthscope $133 882%
Illinois Breast And Cervical Cancer Program $133 882%
Interplan $133 882%
Live360 $133 882%
Wexford $133 882%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals