Blood test, vitamin B12
Facility: Jewell County Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $71
- Cash Discount Price: $56
- vs. Medicare Baseline: 4.71x 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 471% of the Medicare baseline (a markup of 371%). 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 |
|---|---|---|
| Rural Carriers - All Plans | $64 | 424% |
| Meritain - All Plans | $68 | 451% |
| Aetna | $68 | 451% |
| First Health - All Plans | $71 | 471% |
| Midlands Choice - All Plans | $71 | 471% |
| UnitedHealthcare | $71 | 471% |
| Cigna | $71 | 471% |
Consumer Guidance & Cost Commentary
For the CPT code 82607, representing a blood test for vitamin B12, the facility in Mankato, Kansas, lists a cash median price of $56.00, which is lower than the state average of $71.00. While the facility's negotiated rate with most insurance carriers is $71.00, the cash price offers a potential savings of $15.00 for patients who can pay directly. It is important to note that for individuals with high-deductible plans, paying the cash price upfront may be more cost-effective than using insurance, as the negotiated rate often exceeds the cash price. Patients should verify if the facility offers additional "self-pay" or "prompt-pay" discounts before scheduling, as these incentives can further reduce the final amount owed.
The Medicare benchmark for this service is $15.08, which serves as a baseline for evaluating the facility's pricing structure. The facility's cash rate of $56.00 represents approximately 370% of the Medicare amount, while the negotiated rate of $71.00 is roughly 470% of the Medicare benchmark. This significant markup is common in commercial billing, where administrative costs and contract dynamics influence the final price. To ensure you are not overcharged, it is recommended to request an itemized billing audit before payment, as summary bills often obscure individual line items and may contain errors such as unbundled codes or charges for services not rendered. Disputing any inaccuracies should be done in writing to protect your rights and prevent unnecessary medical debt.