CMS Price Transparency Data

Blood test, vitamin B12

Facility: Rochelle Community Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $128
Cash Discount Price: $171
vs. Medicare Baseline: 8.49x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Rochelle Community Hospital is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $171. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 8.49x the Medicare baseline. Located in 900 N 2Nd St, Rochelle, IL.

Cash / Self-Pay

$171

Average discount available for prompt cash payment at this facility.

Insurance Median

$128

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: $171 (1134%)

Insurance Median: $128 (849%)

Cash: $171 (1134% of Medicare)

Ins. Median: $128 (849% 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 849% of the Medicare baseline (a markup of 749%). 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
Aetna	$18 - $60	119%
Blue Cross Blue Shield	$18 - $171	119%
Medicaid / KanCare	$18	119%
The Alliance-All Plans	$26	172%
Health Alliance Mcr Adv	$60	398%
Humana	$60 - $137	398%
UnitedHealthcare	$60 - $154	398%
Va Ccn - All Plans	$60	398%
Wellcare Mcr Adv - All Plans	$61	405%
Cigna	$128	849%
Osf Dan Ppo - All Plans	$128	849%
Beech Street-All Plans	$137	908%
First Health - All Plans	$137	908%
Health Alliance-All Other Plans	$137	908%
Ecoh-All Plans	$145	962%
Hfn-All Plans	$145	962%
Quartz Health Solutions-All Plans	$150	995%
Multiplan-All Plans	$161	1068%

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 $171.
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 Rochelle Community 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.