CMS Price Transparency Data

Blood test, vitamin B12

Facility: Saint Joseph Regional Medical Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $80
  • Cash Discount Price: $196
  • vs. Medicare Baseline: 5.31x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Saint Joseph Regional Medical Center is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $196. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 5.31x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$196

Average discount available for prompt cash payment at this facility.

Insurance Median
$80

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: $196 (1300%)
Insurance Median: $80 (531%)
Cash: $196 (1300% of Medicare)
Ins. Median: $80 (531% 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 531% of the Medicare baseline (a markup of 431%). 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
Aetna $8 - $147 53%
Blue Cross Blue Shield $8 - $30 53%
Medicaid / KanCare $8 - $15 53%
UnitedHealthcare $8 - $192 53%
Managed Health Services - Indiana $15 99%
Mdwise $15 99%
Medicare (plans) $15 99%
Meridian Complete $15 99%
Pace-Trinity Health $15 99%
County Coroner $16 106%
Provider Partners Health Plan Of Indiana $17 113%
Auxiant $23 - $250 153%
Caresource $23 153%
Physicians Health Plan Northern Indiana Health Insurance $23 - $46 153%
St Joseph County Hlth Dpt $23 153%
Siho Insurance Services $24 159%
Key Benefit Administrator $27 - $187 179%
Allied Benefit Systems $29 - $196 192%
Blue Benefit Administrators Of Massachusetts $30 199%
Blue Care Network $30 199%
Blue Distinction Transplant $30 199%
Blue Shield - Ca $30 199%
Blue Shield - Id (Regence) $30 199%
Blue Shield - Ny Highmark Northeastern $30 199%
Blue Shield - Ny Highmark Western $30 199%
Blue Shield - Pa (Highmark) $30 199%
Blue Shield - Wa (Regence) $30 199%
Custom Design Benefits $32 212%
Hospice Of Marshall County $78 517%
Hospice Of St Joseph County $78 517%
Plain Church Group $81 537%
Asr Health Benefits $147 975%
Christian Brother Services $147 975%
Employee Benefit Management $147 975%
Medical Mutual $147 975%
Meritain $147 975%
Preferred One $147 975%
Rural Carrier Health Benefit Plan $147 975%
Webtpa $147 975%
Notre Dame Athletic Association $166 1101%
Wc Notre Dame $166 1101%
Luminare Health (Detroit) $172 - $181 1141%
Encore Health $178 - $187 1180%
Ameriben $181 1200%
Indiana Criminal Justice Inst $187 1240%
Western & Southern Financial Group $187 1240%
Geha $192 1273%
Healthscope $192 1273%
Student Insurance Cma $192 1273%
Cigna $193 1280%
Group Administrators $193 1280%
Health Partners $193 1280%
Mvp $193 1280%
Prairie States $193 1280%
Priority Health $193 1280%
Professional Benefit Administrators $193 1280%
Sagamore Health Network $193 - $223 1280%
Sisco Benefits $193 1280%
Unified Group Services $193 1280%
Goshen Preferred Network $232 - $259 1538%
Christian Brothers Holy Cross $241 1598%
Signature Care $241 1598%
Bankers Life Casualty $301 1996%
Bureau Of Disability $301 1996%
Wc Align Network $301 1996%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals