Blood test, vitamin B12
Facility: Lmh
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $15
- Cash Discount Price: $30
- vs. Medicare Baseline: 0.99x 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $14 - $77 | 93% |
| UnitedHealthcare | $14 - $46 | 93% |
| Medicare (plans) | $15 | 99% |
| Allwell | $15 | 99% |
| Cigna | $15 - $79 | 99% |
| Haskell Indian Health Services | $15 | 99% |
| Humana | $15 | 99% |
| Aetna | $17 - $99 | 113% |
| Ambetter / Centene | $23 | 153% |
| Non Contracted | $95 | 630% |
| First Health | $110 | 729% |
Consumer Guidance & Cost Commentary
For the CPT code 82607, representing a blood test for vitamin B12, the facility in Lawrence, KS, lists a gross charge of $119.00. This amount is significantly higher than the cash median of $30.00 and exceeds the Medicare benchmark of $15.08, which serves as the federally established baseline for the true cost of this service. While the facility offers a negotiated rate of $15.00, this figure remains above the cash price and is comparable to the state average for this procedure. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the negotiated rate often exceeds the cash amount due to administrative overheads and contract structures. It is important to note that the facility, owned by the local government, reports a facility rating of 4, and while specific negotiated rates vary by payer, the cash option provides a clear, lower-cost alternative for those without active insurance coverage.
Insurance coverage for this service varies widely across payers, with allowed amounts ranging from $14 to $99 depending on the plan. For instance, Blue Cross Blue Shield and UnitedHealthcare have negotiated ranges starting at $14, while Cigna's range extends up to $79. However, patients should be aware that commercial negotiated rates frequently include administrative costs that inflate the baseline price by 20% to 40% compared to the actual service cost. To ensure you are receiving the best possible rate, it is recommended to request an itemized billing audit before finalizing payment, as summary bills often obscure individual line items and potential errors. Additionally, inquiring about prompt-pay discounts prior to scheduling