CMS Price Transparency Data

Blood test, vitamin B12

Facility: Clara Barton Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $142
  • Cash Discount Price: $111
  • vs. Medicare Baseline: 9.42x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Clara Barton Hospital is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 9.42x the Medicare baseline. Located in 250 W 9Th Street, Hoisington, KS.
Cash / Self-Pay
$111

Average discount available for prompt cash payment at this facility.

Insurance Median
$142

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$15.08

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $15.08 (100%)
Cash / Self-Pay: $111 (736%)
Insurance Median: $142 (942%)
Cash: $111 (736% of Medicare)
Ins. Median: $142 (942% of 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 942% of the Medicare baseline (a markup of 842%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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%
6 Degrees Health - All Plans $111 736%
Wppa-All Plans $126 836%
Aetna $142 942%
UnitedHealthcare $142 942%
Phcs - All Plans $142 942%
Hlth Partners Of Ks-All Plans $145 962%

Consumer Guidance & Cost Commentary

For the CPT code 82607 (Blood test, vitamin B12) at Clara Barton Hospital in Hoisington, KS, the cash median price is $111.00, which is lower than the facility's negotiated rates of $142.00 and the Medicare benchmark of $15.08. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that insurance negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. If you have a high-deductible plan, paying the cash price of $111.00 upfront could result in significant savings compared to your insurance paying its allowed amount of $119.00, provided you have not yet met your deductible. To maximize these savings, it is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling your visit.

This specific service does not include comparative data against Kansas or county averages in the current dataset, so no state or regional price comparisons can be made. However, the data highlights the importance of understanding balance billing risks, particularly if you receive care from out-of-network providers or ancillary services like emergency physicians at an in-network facility. Under the No Surprises Act, you are protected from balance billing for emergency and non-emergency services at in-network hospitals, but you should still request an itemized bill to ensure no unbundled codes or services not rendered are included. If you receive a bill that appears inflated, you have the right to dispute it in writing with the billing supervisor rather than accepting a summary invoice or signing away your rights via consent waivers.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 W 9Th Street, Hoisington, KS 67544
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals