Blood test, vitamin B12
Facility: F W Huston Medical Center
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $124
- Cash Discount Price: $128
- vs. Medicare Baseline: 8.22x 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 822% of the Medicare baseline (a markup of 722%). 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% |
| Aetna | $120 | 796% |
| Humana | $127 | 842% |
| Cigna | $136 | 902% |
Consumer Guidance & Cost Commentary
For this vitamin B12 blood test at F W Huston Medical Center in Winchester, KS, the facility's cash price of $128.00 is notably higher than the median negotiated rate of $124.00, which may seem counterintuitive but often occurs when insurance administrative costs inflate the allowed amount. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance contracts often include multi-layered administrative structures that can raise the baseline price by 20% to 40% above the true cost of care. Because the cash price is lower than the median negotiated rate, paying out-of-pocket could result in significant savings for individuals with high-deductible plans who have not yet met their coverage thresholds, effectively bypassing the inflated administrative fees embedded in the insurance process.
When evaluating the value of this service, it is important to compare the facility's rates against the Medicare benchmark, which serves as the scientifically validated cost baseline for healthcare delivery. The Medicare amount for this code is $15.08, and the facility's cash price represents a markup of 8.2 times this federal rate, which aligns with the typical range where fair pricing is defined as 120% to 150% of Medicare, though commercial contracts often average 200% to 300%. To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as hospitals frequently offer fee reductions of 20% to 50% for upfront payments that bypass costly claims processing. Additionally, since the No Surprises Act prohibits balance billing for emergency and non-emergency services at