CMS Price Transparency Data

Blood test, vitamin B12

Facility: Valley West Community Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $124
  • Cash Discount Price: $135
  • vs. Medicare Baseline: 8.22x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Valley West Community Hospital is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $135. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 8.22x the Medicare baseline. Located in 11 East Pleasant Avenue, Sandwich, IL.
Cash / Self-Pay
$135

Average discount available for prompt cash payment at this facility.

Insurance Median
$124

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: $135 (895%)
Insurance Median: $124 (822%)
Cash: $135 (895% of Medicare)
Ins. Median: $124 (822% 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 822% of the Medicare baseline (a markup of 722%). 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 $37 - $158 245%
Global Excel [1712] $37 245%
Humana $37 245%
Aetna $49 - $134 325%
Health'S Finest Network [126] $87 - $164 577%
The Alliance [1703] $105 696%
Choicecare [177] $130 862%
Healthlink [125] $145 962%
Multiplan/Phcs [142] $154 - $193 1021%
First Health Plan [6034] $193 1280%
UnitedHealthcare $193 1280%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11 East Pleasant Avenue, Sandwich, IL 60548
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals