Blood test, vitamin B12
Facility: Mcpherson Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $98
- Cash Discount Price: $116
- vs. Medicare Baseline: 6.50x 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 650% of the Medicare baseline (a markup of 550%). 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 |
|---|---|---|
| Tricare | $13 | 86% |
| Wellcare Mcr Adv - All Plans | $15 | 99% |
| Healthy Blue Mcr Adv | $15 | 99% |
| Blue Cross Blue Shield | $15 | 99% |
| Va Ccn - All Plans | $15 | 99% |
| Humana | $15 | 99% |
| UnitedHealthcare | $15 - $213 | 99% |
| Ambetter / Centene | $17 | 113% |
| Wppa - All Plans | $71 - $149 | 471% |
| Medical Associates - All Plans | $76 - $160 | 504% |
| Central Plains - All Plans | $76 - $160 | 504% |
| Christian Health Aid - All Plans | $81 - $170 | 537% |
| Aetna | $83 - $213 | 550% |
| Multiplan - All Plans | $91 - $192 | 603% |
| Health Partners - All Plans | $96 - $202 | 637% |
| First Health - All Plans | $96 - $202 | 637% |
| Cigna | $96 - $202 | 637% |
| Medicaid / KanCare | $101 - $213 | 670% |
| Health Blue Mcaid - All Other Plans | $103 - $217 | 683% |
Consumer Guidance & Cost Commentary
For the CPT code 82607, representing a blood test for vitamin B12, McPherson Hospital in Kansas lists a gross charge of $157.00. This amount is significantly higher than the Medicare benchmark of $15.08, which serves as the federal baseline for the true cost of this service. While the facility offers a cash median price of $116.00 and a negotiated median of $98.00, these figures remain well above the Medicare rate. It is important to note that commercial insurance plans, such as UnitedHealthcare and Aetna, have negotiated rates ranging from $13 to $213, meaning that for some patients with high-deductible plans, paying the cash price of $116.00 upfront could result in lower out-of-pocket costs than relying on insurance reimbursement, especially if the insurer's allowed amount exceeds the cash rate.
Patients should be aware that the facility's cash rate is not necessarily the lowest possible option, as many commercial payers negotiate rates that can exceed the cash price due to administrative overhead and contract dynamics. For instance, UnitedHealthcare's range of $13 to $213 and Medicaid/KanCare's range of $101 to $213 illustrate how insurance negotiations can inflate the baseline price. To secure the most favorable rate, individuals should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% for upfront payment. Additionally, since the facility is an in-network location for many major carriers, patients should verify their specific plan's deductible status before scheduling