Blood test, vitamin B12
Facility: Nmc Health
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $107
- Cash Discount Price: $115
- vs. Medicare Baseline: 7.10x 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 710% of the Medicare baseline (a markup of 610%). 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 |
|---|---|---|
| Aetna | $48 | 318% |
| Blue Cross Blue Shield | $57 | 378% |
| Wppa | $90 | 597% |
| Occunet | $98 | 650% |
| Samaritan Ministries International | $107 | 710% |
| Medincrease Health Plan | $107 | 710% |
| Prime Health Services | $123 | 816% |
| UnitedHealthcare | $148 | 981% |
| Cigna | $156 | 1034% |
Consumer Guidance & Cost Commentary
For this vitamin B12 blood test at Nmc Health in Newton, Kansas, the cash price of $115.00 is notably lower than the facility's gross charge of $164.00. While the facility's negotiated rates for in-network payers range from $48 to $156, the cash price remains the most consistent baseline for patients without insurance. It is important to note that cash payments can sometimes be cheaper than insurance reimbursement, particularly for patients with high-deductible plans where the insurer's allowed amount might exceed the cash price. To maximize savings, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative costs associated with insurance billing cycles.
The facility's pricing is evaluated against federal benchmarks to ensure transparency. The Medicare amount for this service is $15.08, which serves as the objective baseline for evaluating commercial rate markups. Although the data does not provide specific state or county average figures for comparison, the facility's negotiated rates generally fall within the range of $48 to $156 across nine different payers. Patients should be aware that commercial negotiated rates often include administrative overhead and can be higher than the cash price due to multi-layered contract dynamics. If a patient receives a bill that exceeds the negotiated rate or the cash price, they should request an itemized billing audit to identify any errors, double-billing, or unbundled codes, as over 80% of hospital bills contain discrepancies that can be corrected.