Blood test, vitamin B12
Facility: Great Plains Of Sabetha
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 |
|---|---|---|
| Celtic Mcr Adv | $42 | 279% |
| Aetna | $43 - $82 | 285% |
| Celtic Comm Exchange-All Other Plans | $53 | 351% |
| Great West Healthcare-All Plans | $69 | 458% |
| UnitedHealthcare | $75 - $81 | 497% |
| Humana | $77 | 511% |
| Multiplan-Phcs-All Plans | $77 | 511% |
| Century/Wppa/Providers-All Plans | $77 | 511% |
| Cigna | $77 | 511% |
| Federated Mutual Ins-All Plans | $78 | 517% |
| Blue Cross Blue Shield | $81 | 537% |
| Medicaid / KanCare | $81 | 537% |
Consumer Guidance & Cost Commentary
For the CPT code 82607 (Blood test, vitamin B12) at Great Plains Of Sabetha in Sabetha, KS, the facility's cash median price is $81.00, which matches the gross chargemaster rate. This cash price is notably higher than the state average for this service, which is $69.00. While the facility offers a negotiated rate of $77.00 for in-network patients, this amount remains above the state average of $69.00. For patients with high-deductible plans, paying the cash price of $81.00 upfront may be more cost-effective than relying on insurance, as the negotiated rate exceeds the cash price. Patients should verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce out-of-pocket costs.
It is important to understand that commercial insurance rates often include administrative overhead and do not reflect the true cost of care, which is better represented by the Medicare benchmark of $15.08. Although the facility is a Critical Access Hospital with voluntary non-profit ownership, the negotiated rates for this test range from $42.00 to $82.00 across different payers, with a median negotiated rate of $77.00. Consumers should be aware that summary bills may obscure individual line items, so requesting a full itemized CPT-coded statement is essential to identify any errors or unbundled charges. If a patient receives a balance bill from an out-of-network provider, they may be entitled to protections under the No Surprises Act,