CMS Price Transparency Data

Blood test, vitamin B12

Facility: Rush Memorial Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $200
Cash Discount Price: $224
vs. Medicare Baseline: 13.26x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Rush Memorial Hospital is $200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 13.26x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$224

Average discount available for prompt cash payment at this facility.

Insurance Median

$200

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: $224 (1485%)

Insurance Median: $200 (1326%)

Cash: $224 (1485% of Medicare)

Ins. Median: $200 (1326% 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 1326% of the Medicare baseline (a markup of 1226%). 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
Health Net	$88	584%
Caresource Mcr Adv	$93	617%
My True Advantage - All Plans	$93	617%
UnitedHealthcare	$93 - $239	617%
Aetna	$94 - $275	623%
Humana	$94 - $275	623%
Blue Cross Blue Shield	$96 - $219	637%
Today'S Option Mcr Adv-All Plans	$96	637%
Viant Beech St Mcr Adv	$96	637%
Caresource Marketplace-All Other Plans	$148	981%
Cigna	$239	1585%
Phcs-All Plans	$239	1585%
Consumers Life Ins-All Plans	$269	1784%
Coventry/First Health-All Plans	$269	1784%
Sagamore-All Plans	$275	1824%
Siho-All Plans	$275	1824%
Multiplan-All Plans	$278	1844%
Community Health Alliance-All Plans	$281	1863%
Encore Health Services-All Plans	$293	1943%

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 $224.
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 Rush Memorial 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.