CMS Price Transparency Data

Blood test, vitamin B12

Facility: Ashland Health Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $85
  • Cash Discount Price: $77
  • vs. Medicare Baseline: 5.64x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Ashland Health Center is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 5.64x the Medicare baseline. Located in 625 South Kentucky Street, Ashland, KS.
Cash / Self-Pay
$77

Average discount available for prompt cash payment at this facility.

Insurance Median
$85

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$15.08

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $15.08 (100%)
Cash / Self-Pay: $77 (511%)
Insurance Median: $85 (564%)
Cash: $77 (511% of Medicare)
Ins. Median: $85 (564% of 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 564% of the Medicare baseline (a markup of 464%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $27 - $37 179%
Compalliance-All Plans $66 - $88 438%
Health Partners Of Kansas-All Plans $70 - $94 464%
Multiplan-All Plans $80 - $108 531%
Healthy Blue Mcr Adv - All Other Plans $82 - $110 544%
Medicaid / KanCare $82 - $110 544%
Aetna $82 - $110 544%
Health Choice-All Plans $82 - $110 544%
Medicare (plans) $82 - $110 544%
Medica Mcare - All Plans $82 - $110 544%
UnitedHealthcare $82 - $110 544%
Providers Care (Wppa)-All Plans $123 - $165 816%

Consumer Guidance & Cost Commentary

For this blood test for vitamin B12 at Ashland Health Center in Ashland, KS, the facility's cash price of $77.00 is lower than the state average of $82.00, making it a cost-effective option for patients paying out-of-pocket. While many commercial payers have negotiated rates ranging from $82.00 to $110.00, these amounts often exceed the cash price, which can be advantageous for those with high-deductible plans who may not yet have met their coverage thresholds. It is important to note that while the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees.

The facility's negotiated rates for this service are significantly higher than the Medicare benchmark of $15.08, with most commercial plans paying between $82.00 and $165.00 depending on the specific plan. This disparity highlights that commercial rates often include administrative costs and contract premiums that are not reflected in the federal cost baseline. If you are using insurance, be aware that while the facility is in-network for most major carriers, the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, though you should still verify your specific plan's allowed amount to avoid unexpected costs. Always request an itemized bill to ensure all charges are accurate and to identify any potential errors before finalizing payment.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 625 South Kentucky Street, Ashland, KS 67831
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals