Blood test, vitamin B12
Facility: Graham County Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $60
- Cash Discount Price: $84
- vs. Medicare Baseline: 3.98x 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 398% of the Medicare baseline (a markup of 298%). 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 |
|---|---|---|
| UnitedHealthcare | $13 - $80 | 86% |
| Medicaid / KanCare | $24 | 159% |
| Blue Cross Blue Shield | $57 | 378% |
| Medicare (plans) | $63 | 418% |
| Celtic Commercial-All Other Plans | $69 | 458% |
| Wppa (Providers Care)-All Plans | $80 | 531% |
Consumer Guidance & Cost Commentary
For this vitamin B12 blood test at Graham County Hospital in Hill City, KS, the cash price is $84.00, which matches the facility's negotiated rates for UnitedHealthcare, Medicaid/KanCare, and Blue Cross Blue Shield. While the facility is a Critical Access Hospital owned by the local government, the cash price is notably higher than the state average for this service. Patients with high-deductible plans or those without insurance may find paying cash directly more cost-effective than using insurance, as the negotiated rates for major payers like UnitedHealthcare and Medicare (plans) are significantly higher than the cash price. It is important to note that while the facility offers prompt-pay discounts for upfront payment, these rates are not automatically applied; patients must explicitly request a self-pay classification and sign a waiver of insurance submission before check-in to ensure the discount is honored.
The Medicare allowed amount for this procedure is $15.08, which serves as a key benchmark for evaluating the facility's pricing structure. The cash price of $84.00 represents a substantial markup compared to the Medicare rate, illustrating the difference between federal cost-based reimbursement and commercial pricing. Although the facility's negotiated rates for Medicaid and Blue Cross Blue Shield are relatively low at $24.00 and $57.00 respectively, these amounts still exceed the Medicare benchmark. Consumers should be aware that balance billing is generally prohibited for emergency services and non-emergency care at in-network facilities under the No Surprises Act, but unexpected charges can still occur if ancillary services like lab tests are billed out-of-network. To avoid surprise costs, patients should request a full itemized bill before payment and verify that all services listed were actually