CMS Price Transparency Data

Blood test, vitamin B12

Facility: Clay County Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $141
  • Cash Discount Price: $228
  • vs. Medicare Baseline: 9.35x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Clay County Hospital is $141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 9.35x the Medicare baseline. Located in 911 Stacy Burk Dr, Flora, IL.
Cash / Self-Pay
$228

Average discount available for prompt cash payment at this facility.

Insurance Median
$141

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: $228 (1512%)
Insurance Median: $141 (935%)
Cash: $228 (1512% of Medicare)
Ins. Median: $141 (935% 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 935% of the Medicare baseline (a markup of 835%). 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 $4 - $167 27%
UnitedHealthcare $6 - $182 40%
Aetna $62 - $180 411%
Ambetter / Centene $62 411%
Medica(Wellfirst) $62 - $141 411%
Meridian $62 411%
Wellcare $62 411%
Healthlink $148 - $182 981%
Cigna $182 1207%
Usa Mco $217 1439%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 911 Stacy Burk Dr, Flora, IL 62839
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals