Blood test, vitamin B12
Facility: Hamilton County Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $90
- Cash Discount Price: $100
- vs. Medicare Baseline: 5.97x 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 597% of the Medicare baseline (a markup of 497%). 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 | $27 - $57 | 179% |
| First Health Coventry - All Plans | $85 | 564% |
| Cigna | $95 | 630% |
| UnitedHealthcare | $95 | 630% |
| Va Ccn - All Plans | $100 | 663% |
| Aetna | $170 | 1127% |
Consumer Guidance & Cost Commentary
For the CPT code 82607, representing a blood test for vitamin B12, Hamilton County Hospital in Syracuse, KS, lists a cash median price of $100.00. This cash rate is notably higher than the state average, which is $60.00, indicating that paying out-of-pocket may not be the most cost-effective option for patients without insurance. While the facility offers a negotiated rate of $90.00 for commercial payers like Blue Cross Blue Shield and Cigna, these rates are still above the state average of $60.00. Patients should be aware that commercial negotiated rates often include administrative overhead and contract premiums, making them higher than the true cost of care represented by the Medicare benchmark of $15.08.
Given that the cash price of $100.00 is lower than the median negotiated rates of $90.00 to $170.00 seen across various payers, patients with high-deductible plans might find it beneficial to pay the cash price directly to avoid out-of-pocket costs exceeding the $100.00 threshold. However, patients must verify if the hospital offers a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is also important to request an itemized billing audit to ensure no errors exist, as over 80% of hospital bills contain mistakes that could be corrected. Finally, while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, patients should confirm their plan's specific coverage details to avoid unexpected