Blood test, vitamin B12
Facility: Wichita County Health Center
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $83
- Cash Discount Price: $73
- vs. Medicare Baseline: 5.50x 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 550% of the Medicare baseline (a markup of 450%). 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 |
|---|---|---|
| Medicaid / KanCare | $74 - $76 | 491% |
| UnitedHealthcare | $90 - $92 | 597% |
Consumer Guidance & Cost Commentary
For this blood test for vitamin B12 at Wichita County Health Center in Leoti, Kansas, the facility's cash median price of $73.00 is lower than the state average of $75.00 and the county average of $73.00. While Medicaid/KanCare plans negotiate a range between $74 and $76, and UnitedHealthcare plans pay between $90 and $92, patients with high-deductible plans may find paying cash directly more affordable. Because the cash price is below the negotiated rates, it can be financially advantageous to pay out-of-pocket, provided you verify the specific terms with the hospital regarding "self-pay" or "prompt-pay" discounts before scheduling your visit.
It is important to understand that the facility's gross charge of $91.00 is significantly higher than the Medicare benchmark of $15.08, illustrating how commercial rates often exceed the federal cost baseline. If you receive a bill from this out-of-network provider that exceeds the allowed amount, you may be facing balance billing, which is the practice of being charged the difference between the provider's full rate and what your insurance pays. Under the No Surprises Act, you are protected from balance billing for emergency care and non-emergency services at in-network facilities, so if you receive such a bill, you should dispute it with your insurer rather than paying immediately. Additionally, since over 80% of hospital bills contain errors, you should request a full itemized statement to review every code and ensure no services were unbundled or incorrectly charged before finalizing payment.