Blood test, vitamin B12
Facility: Pratt Regional Medical Center
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $100
- Cash Discount Price: $80
- vs. Medicare Baseline: 6.63x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 663% of the Medicare baseline (a markup of 563%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Christian Health Aid | $86 | 570% |
| UnitedHealthcare | $95 - $116 | 630% |
| Health Partners Of Kansas | $97 | 643% |
| Aetna | $103 | 683% |
| Choicecare | $114 | 756% |
Consumer Guidance & Cost Commentary
For this vitamin B12 blood test at Pratt Regional Medical Center, the cash price of $80.00 is notably lower than the facility's gross charge of $114.00 and the median negotiated rate of $100.00. While commercial payers like UnitedHealthcare and Aetna have negotiated rates ranging from $95 to $116, patients with high-deductible plans may find the cash price more advantageous if their insurance allowed amount exceeds $80.00. It is important to note that the facility's cash rate is significantly higher than the Medicare benchmark of $15.08, reflecting the standard markup for commercial services, but remains competitive when compared to the broader market context of Kansas.
To maximize savings, patients should verify if the hospital offers a "prompt-pay" discount for upfront payment, which can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees. Additionally, since the facility is an in-network location for most major carriers, the No Surprises Act protects patients from unexpected balance billing for out-of-network services rendered at this acute care hospital. Before scheduling, it is recommended to request a formal itemized bill to ensure all charges are accurate and to confirm that no services were inadvertently billed at the full chargemaster rate rather than the negotiated or cash price.