CMS Price Transparency Data

Blood test, vitamin B12

Facility: Woodlawn Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $41
Cash Discount Price: $141
vs. Medicare Baseline: 2.72x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Woodlawn Hospital is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $141. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 2.72x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$141

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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: $141 (935%)

Insurance Median: $41 (272%)

Cash: $141 (935% of Medicare)

Ins. Median: $41 (272% 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 272% of the Medicare baseline (a markup of 172%). 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
Blue Cross Blue Shield	$7 - $143	46%
Caresource Mcaid Hww	$15	99%
Mdwise Excel Hhw & Hcc	$15	99%
Mhs Mcaid Hcc	$15	99%
Mhs Mcaid Hhw	$15	99%
UnitedHealthcare	$15 - $143	99%
Partners Direct Health-All Plans	$28	186%
Aetna	$41 - $179	272%
Caresource Mcaid Hip	$41	272%
Caresource Mcr Adv	$41	272%
Humana	$41 - $146	272%
Mdwise Mcaid Excel Hip	$41	272%
Mhs Exch Mrktplce-All Other Plans	$41	272%
Mhs Mcaid Hip	$41	272%
Mhs Mcr Adv	$42	279%
Caresource Exch - All Other Plans	$54	358%
Ambetter / Centene	$55	365%
Cigna	$135 - $160	895%
Parkview Health Plans-All Plans	$141	935%
Sagamore All Other Grps - All Other Plans	$158	1048%
Encore Comm-All Plans	$160	1061%
Phcs/Multiplan-All Plans	$175	1160%
Community Health Alliance-All Plans	$179	1187%

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 $141.
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 Woodlawn 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.