Blood test, vitamin B12
Facility: Lane County Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $103
- Cash Discount Price: $103
- vs. Medicare Baseline: 6.83x 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 683% of the Medicare baseline (a markup of 583%). 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 | $92 - $97 | 610% |
| UnitedHealthcare | $92 - $102 | 610% |
| Healthy Blue Mcr Adv - All Other Plans | $102 | 676% |
| Healthy Blue Mcaid | $102 | 676% |
| Medicaid / KanCare | $102 - $113 | 676% |
| Wppa Providers-All Plans | $154 | 1021% |
Consumer Guidance & Cost Commentary
For this blood test for vitamin B12 at Lane County Hospital in Dighton, KS, the cash price is $103.00, which matches the facility's negotiated rate and the state average. While commercial payers like Aetna and UnitedHealthcare negotiate rates ranging from $92 to $113, these amounts are generally higher than the cash price. Because insurance contracts often include administrative overhead and do not reflect the true cost of care, paying cash directly can sometimes result in a lower out-of-pocket expense for patients with high-deductible plans. It is important to verify the specific "self-pay" or "prompt-pay" discount available at the hospital before scheduling, as paying upfront can bypass the higher negotiated rates charged to insurance plans.
The Medicare benchmark for this service is $15.08, which serves as the objective baseline for evaluating pricing markups. Commercial rates, including the negotiated amounts, average 200% to 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of this baseline. Since the facility is a Critical Access Hospital owned by a government hospital district, the pricing structure is regulated to ensure transparency. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is still advisable to request an itemized bill to confirm that all charges align with the negotiated or cash rates before finalizing payment.