Blood test, vitamin B12
Facility: Ellinwood District Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $56
- Cash Discount Price: $69
- vs. Medicare Baseline: 3.71x 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 371% of the Medicare baseline (a markup of 271%). 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 | $41 - $72 | 272% |
| Humana | $41 - $72 | 272% |
| Cigna | $41 - $72 | 272% |
| Aetna | $41 - $72 | 272% |
| Blue Cross Blue Shield | $41 - $72 | 272% |
Consumer Guidance & Cost Commentary
For the CPT code 82607, representing a blood test for vitamin B12, the facility cash price is $69.00, which is lower than the state average of $71.00. While the facility's negotiated rates with major payers like UnitedHealthcare, Humana, and Cigna range between $41.00 and $72.00, these figures are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $69.00 rate can be cheaper than the negotiated amount their insurance would allow. It is important to verify the specific "self-pay" or "prompt-pay" discount offered by the hospital before scheduling, as paying upfront can sometimes reduce the final bill further.
The Medicare benchmark for this service is $15.08, which serves as the objective baseline for evaluating pricing markups. The facility's gross charge of $81.00 is significantly higher than the Medicare rate, illustrating why comparing commercial rates to the chargemaster list is misleading; instead, rates should be compared against the Medicare amount to understand the true cost. The facility, Ellinwood District Hospital, is a Critical Access Hospital in Ellinwood, KS, and while the data does not provide a specific facility rating, the pricing transparency shows that the cash price remains competitive relative to the state average. Consumers should request an itemized bill to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal audit dispute.