Blood test, vitamin B12
Facility: Wamego Health Center
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $16
- Cash Discount Price: $34
- vs. Medicare Baseline: 1.06x 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.
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 | $15 | 99% |
| Providrs Care | $15 | 99% |
| Medicaid / KanCare | $16 | 106% |
| Aetna | $16 | 106% |
| Blue Cross Blue Shield | $71 - $76 | 471% |
Consumer Guidance & Cost Commentary
For the CPT code 82607 (Blood test, vitamin B12) at Wamego Health Center in Wamego, KS, the cash median price is $34.00, which is significantly lower than the facility's gross charge of $84.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range between $15 and $16, these amounts are still higher than the cash price. This pricing structure highlights a common billing dynamic where paying out-of-pocket can be more cost-effective for patients with high-deductible plans, as the insurance negotiated rate often exceeds the cash price. To maximize savings, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the total cost.
When evaluating this price, it is important to compare it against the Medicare benchmark rather than the facility's inflated gross charges. The Medicare amount for this service is $15.08, and the facility's negotiated rate of $16.00 is only slightly above this federal baseline, suggesting a relatively fair pricing model compared to commercial chargemasters. However, patients should remain vigilant regarding balance billing, particularly if they receive care from out-of-network providers or ancillary services like emergency physicians, where the provider may bill the difference between their full rate and the insurance allowed amount. If a surprise bill arises, consumers should dispute it in writing and request a No Surprises Act audit to avoid unexpected costs.