Blood test, vitamin D
Facility: Rooks County Health Center
Billing Code: 82306 (CPT)
- CPT Billing Code: 82306
- Insurance Median: $334
- Cash Discount Price: $278
- vs. Medicare Baseline: 11.28x 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 $29.6 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 1128% of the Medicare baseline (a markup of 1028%). 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 | $110 | 372% |
| Tricare | $174 | 588% |
| Celtic Mcr Adv | $174 | 588% |
| Celtic Comm - All Other Plans | $192 | 649% |
| Blue Cross Blue Shield | $218 | 736% |
| UnitedHealthcare | $334 | 1128% |
| Aetna | $334 | 1128% |
| Preferred Benefits Admin | $334 | 1128% |
| Health Partners - All Plans | $353 | 1193% |
| Preferred Hlthcare - All Other Plans | $353 | 1193% |
| Healthy Blue Mcaid - All Plans | $371 | 1253% |
Consumer Guidance & Cost Commentary
For CPT code 82306, a blood test for vitamin D, Rooks County Health Center in Plainville, KS, has a gross charge of $371.00. The facility's cash median price is $278.00, which is lower than the median negotiated rate of $334.00 paid by most insurance plans. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find the cash price more affordable if their insurance negotiated rate exceeds $278.00. It is important to note that the cash price is also lower than the Medicare amount of $29.60, suggesting that the facility's billing structure for this specific service differs significantly from federal reimbursement standards.
When comparing pricing against broader benchmarks, the facility's cash rate of $278.00 is notably lower than the state average for this procedure, though specific county averages were not provided in the data. The median negotiated rate of $334.00 aligns with the median paid amount, indicating consistent pricing across the 11 payer plans listed, ranging from $110 for Veterans Admin to $371 for Healthy Blue Mcaid. 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 a self-pay or prompt-pay discount before scheduling to avoid being billed the full negotiated amount. Always verify your specific plan's deductible status and ask the billing department for an itemized statement to ensure no unexpected charges are included.