CMS Price Transparency Data

Blood test, vitamin B12

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $125
  • Cash Discount Price: $166
  • vs. Medicare Baseline: 8.29x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Saint Joseph Regional Medical Center - Plymouth is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 8.29x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$166

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $166 (1101%)
Insurance Median: $125 (829%)
Cash: $166 (1101% of Medicare)
Ins. Median: $125 (829% 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 829% of the Medicare baseline (a markup of 729%). 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 - $125 53%
Blue Cross Blue Shield $8 - $30 53%
Medicaid / KanCare $8 - $15 53%
UnitedHealthcare $8 - $163 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 - $212 153%
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 - $180 179%
Allied Benefit Systems $29 - $166 192%
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%
Plain Church Group $69 458%
Asr Health Benefits $125 829%
Christian Brother Services $125 829%
Employee Benefit Management $125 829%
Medical Mutual $125 829%
Meritain $125 829%
Preferred One $125 829%
Rural Carrier Health Benefit Plan $125 829%
Webtpa $125 829%
Notre Dame Athletic Association $141 935%
Wc Notre Dame $141 935%
Luminare Health (Detroit) $146 - $154 968%
Ameriben $154 1021%
Geha $163 1081%
Healthscope $163 1081%
Student Insurance Cma $163 1081%
Encore Health $180 1194%
Indiana Criminal Justice Inst $180 1194%
Western & Southern Financial Group $180 1194%
Cigna $184 1220%
Group Administrators $184 1220%
Health Partners $184 1220%
Mvp $184 1220%
Prairie States $184 1220%
Priority Health $184 1220%
Professional Benefit Administrators $184 1220%
Sagamore Health Network $184 - $197 1220%
Sisco Benefits $184 1220%
Unified Group Services $184 1220%
Goshen Preferred Network $197 - $220 1306%
Signature Care $212 1406%
Allied National Global Care $230 1525%
Asrm - Reliance Standard Life Insurance $230 1525%
Avmed Health Plan $230 1525%
Christian Care Ministry $230 1525%
Dean Health $230 1525%
Fallon Health $230 1525%
Family Life Insurance Company $230 1525%
Freedom Life Insurance Company $230 1525%
Ghc Scw $230 1525%
International Benefit Administrators $230 1525%
Lifetime Benefit Solutions $230 1525%
Manhattan Life $230 1525%
Medi Share $230 1525%
Multiplan $230 1525%
Pai $230 1525%
Pan-American Life $230 1525%
Paramount Hmo $230 1525%
Phcs $230 1525%
Philadelphia American Life Insurance $230 1525%
Trinity Health Share $230 1525%
Bankers Life Casualty $256 1698%
Bureau Of Disability $256 1698%
Wc Align Network $256 1698%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1915 Lake Ave, Plymouth, IN 46563
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals