Blood test, vitamin B12
Facility: Nemaha Valley Community Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $77
- Cash Discount Price: $134
- vs. Medicare Baseline: 5.11x 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 511% of the Medicare baseline (a markup of 411%). 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 |
|---|---|---|
| Va Ccn - All Plans | $22 | 146% |
| Aetna | $66 - $127 | 438% |
| Humana | $66 | 438% |
| Celtic Comm Exch - All Plans | $72 | 477% |
| Partners Direct Health - All Plans | $77 | 511% |
| Multiplan - All Plans | $134 | 889% |
| Health Partners - All Plans | $142 | 942% |
| Midlands Choice - All Plans | $142 | 942% |
Consumer Guidance & Cost Commentary
For this blood test for vitamin B12 at Nemaha Valley Community Hospital in Seneca, KS, the cash price of $134.00 is notably lower than the facility's negotiated rates with most major payers, which range from $66 to $142. While the median negotiated rate across these contracts is $77.00, the cash price remains competitive, especially for patients with high-deductible plans where paying out-of-pocket might be more cost-effective than facing a negotiated rate that exceeds the cash price. It is important to note that the facility's cash rate is also higher than the Medicare benchmark of $15.08, reflecting the standard administrative markup inherent in commercial billing structures.
Patients should be aware that while the facility is a Critical Access Hospital with a voluntary non-profit ownership, the specific negotiated rates vary significantly by insurer, with some plans like Aetna and Humana paying $66.00 while others like Multiplan and Health Partners pay $142.00. To ensure you receive the best possible price, we recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, since over 80% of hospital bills contain errors, we advise requesting a full itemized statement before making any payment to verify that all charges are accurate and that no services were unbundled or duplicated.