Blood test, vitamin B12
Facility: Rooks County Health Center
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $95
- Cash Discount Price: $79
- vs. Medicare Baseline: 6.30x 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 630% of the Medicare baseline (a markup of 530%). 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 |
|---|---|---|
| Veterans Admin - All Plans | $16 | 106% |
| Tricare | $50 | 332% |
| Celtic Mcr Adv | $50 | 332% |
| Celtic Comm - All Other Plans | $55 | 365% |
| Blue Cross Blue Shield | $57 | 378% |
| Preferred Benefits Admin | $95 | 630% |
| Aetna | $95 | 630% |
| UnitedHealthcare | $95 | 630% |
| Preferred Hlthcare - All Other Plans | $100 | 663% |
| Health Partners - All Plans | $100 | 663% |
| Healthy Blue Mcaid - All Plans | $106 | 703% |
Consumer Guidance & Cost Commentary
For the CPT code 82607, representing a blood test for vitamin B12, the facility's cash median price of $79.00 is notably lower than the state average of $106.00 and the negotiated rate of $95.00. While the Medicare benchmark for this service is set at $15.08, commercial insurance plans typically pay significantly higher amounts, ranging from $16 to $106 depending on the specific carrier. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $79.00 upfront may result in immediate savings compared to the higher negotiated rates their insurance would otherwise require. It is important to verify your specific plan's allowed amount before scheduling, as some in-network contracts may exceed the cash-pay rate.
To ensure you are not overcharged, always request a detailed, itemized bill rather than accepting a summary invoice that groups services into broad categories. If you receive a balance bill for the difference between the provider's full charge and your insurance payment, you may be entitled to protections under the No Surprises Act, particularly if the facility is in-network but a specific service was out-of-network. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if settled within 30 days, effectively bypassing the administrative costs associated with insurance claims processing.