Blood test, vitamin B12
Facility: Grisell Memorial Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $75
- Cash Discount Price: $122
- vs. Medicare Baseline: 4.97x 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 497% of the Medicare baseline (a markup of 397%). 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 |
|---|---|---|
| UnitedHealthcare | $19 - $96 | 126% |
| Blue Cross Blue Shield | $54 | 358% |
| Medicaid / KanCare | $128 | 849% |
| Humana | $128 | 849% |
Consumer Guidance & Cost Commentary
For the CPT code 82607 (Blood test, vitamin B12) at Grisell Memorial Hospital in Ransom, KS, the facility's negotiated rates range from $19 to $128 depending on the insurance plan, with a median negotiated amount of $75.00. This facility is a Critical Access Hospital owned by a Government Hospital District, and its pricing structure is significantly lower than the state average, as indicated by a 5.0% variance compared to Medicare rates. While the gross chargemaster lists at $128.00, patients with high-deductible plans may find that paying the cash median of $122.00 upfront is more cost-effective than relying on insurance, which often results in higher out-of-pocket costs due to administrative fees and deductibles.
It is important to note that while the No Surprises Act protects patients from balance billing for emergency services at in-network facilities, unexpected ancillary services like laboratory tests can sometimes trigger separate billing if not properly coordinated. To avoid potential errors or double-charging, patients should request a full itemized bill before paying, as summary invoices often obscure individual code costs. Additionally, since Grisell Memorial Hospital offers prompt-pay discounts for upfront payment, patients should explicitly ask for self-pay or cash rates prior to scheduling their visit to ensure they are not automatically enrolled in a billing cycle that could void any potential discounts.