Blood test, vitamin B12
Facility: Rawlins County Health Center
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $126
- Cash Discount Price: $123
- vs. Medicare Baseline: 8.36x 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 836% of the Medicare baseline (a markup of 736%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $57 | 378% |
| UnitedHealthcare | $126 | 836% |
Consumer Guidance & Cost Commentary
For this blood test for vitamin B12 at Rawlins County Health Center in Atwood, Kansas, the cash median price is $123.00, which is lower than the negotiated rates of $126.00 paid by UnitedHealthcare and $57.00 paid by Blue Cross Blue Shield. While the facility's cash rate is competitive, it is important to note that commercial insurance contracts often include administrative overhead that can inflate the final allowed amount compared to direct cash payment. If you have a high-deductible plan, paying the cash price upfront might result in lower out-of-pocket costs than your insurance allowing, provided you have not yet met your deductible. Always verify the specific "self-pay" or "prompt-pay" discount terms with the hospital before scheduling, as these upfront incentives can further reduce the final bill.
The Medicare benchmark for this service is $15.08, which serves as a baseline for evaluating the facility's pricing markup. The gross charge listed is $145.00, and the negotiated rates for in-network payers are significantly higher than the Medicare amount, reflecting the standard commercial pricing structure. Since this data reflects a Critical Access Hospital in Atwood, KS, with no specific county average provided for comparison, the focus remains on the relationship between the cash price, the Medicare rate, and the negotiated amounts. 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 crucial to request an itemized bill to ensure no unbundled codes or services not rendered are included in the final charge.