Blood test, vitamin B12
Facility: Medicine Lodge Memorial Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $77
- Cash Discount Price: $81
- 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 |
|---|---|---|
| Tricare | $64 - $65 | 424% |
| Humana | $73 - $74 | 484% |
| Aetna | $74 - $81 | 491% |
| UnitedHealthcare | $76 - $77 | 504% |
| Hpk-All Plans | $76 - $77 | 504% |
| Medicaid / KanCare | $80 - $81 | 531% |
Consumer Guidance & Cost Commentary
For the CPT code 82607 (Blood test, vitamin B12) at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the cash price is $81.00, which matches the facility's cash median. This rate is significantly higher than the Medicare benchmark of $15.08, reflecting the typical administrative markup found in commercial billing. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find the cash price more affordable than their insurance negotiated rates, which range from $64 to $81 depending on the payer. It is important to note that commercial negotiated rates often exceed cash prices due to the costs of claims processing and contract management, meaning paying out-of-pocket can sometimes result in lower out-of-pocket costs for the patient.
Before scheduling, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Although the data provided does not include specific county or state average comparisons for this code, the significant gap between the Medicare rate and the facility's cash price highlights the importance of understanding the true cost baseline. If you receive a bill that includes unexpected charges or a summary invoice, you have the right to request a detailed, itemized audit to identify errors such as unbundled codes or services not rendered. Always dispute any balance billing or unexpected charges in writing, as federal protections like the No Surprises Act may apply to out-of-network services at in-network facilities.