Blood test, vitamin B12
Facility: Hiawatha Community Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $114
- Cash Discount Price: $146
- vs. Medicare Baseline: 7.56x 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 756% of the Medicare baseline (a markup of 656%). 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 | $54 - $125 | 358% |
| Aetna | $54 - $118 | 358% |
| Blue Cross Blue Shield | $55 - $57 | 365% |
| Humana | $55 | 365% |
| Ambetter / Centene | $65 | 431% |
| Oscar - All Plans | $110 | 729% |
| Centrus Health Direct - All Plans | $110 | 729% |
| Preferred Hlth - All Plans | $131 | 869% |
| Cigna | $139 | 922% |
| Wppa Providrs Care - All Plans | $139 | 922% |
| Multiplan - All Plans | $142 | 942% |
| Midlands Choice - All Plans | $142 | 942% |
| Healthy Blue Mcaid - All Plans | $146 | 968% |
Consumer Guidance & Cost Commentary
For this blood test for vitamin B12 at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $146.00, which matches the facility's gross charge. While the hospital is a Critical Access Hospital with a voluntary non-profit ownership, the negotiated rates vary significantly by insurer, ranging from $54 to $146. Notably, the median negotiated rate across all payers is $114.00, which is lower than the cash price. This suggests that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $146.00 upfront could be more cost-effective than relying on insurance, as the insurer's allowed amount often exceeds the cash rate. Additionally, patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting the deductible can result in higher out-of-pocket costs than paying cash directly.
The facility's pricing is evaluated against a Medicare benchmark of $15.08, indicating that the cash price represents a significant markup above the federal baseline. Commercial negotiated rates generally average 200% to 300% of Medicare, though this specific service shows a median negotiated rate of $114.00, which is approximately 7.6 times the Medicare amount. To further reduce costs, patients should inquire about "prompt-pay" discounts, which are typically 20% to 50% off the cash price when bills are paid in full within 30 days, effectively bypassing administrative fees associated with insurance claims. Finally, if you receive a bill after using insurance, request a full itemized audit