Blood test, vitamin B12
Facility: Sheridan County Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $79
- Cash Discount Price: $117
- vs. Medicare Baseline: 5.24x 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 524% of the Medicare baseline (a markup of 424%). 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 Insurance | $71 | 471% |
| Blue Cross Blue Shield | $79 | 524% |
| UnitedHealthcare | $111 | 736% |
Consumer Guidance & Cost Commentary
For the CPT code 82607 (Blood test, vitamin B12) at Sheridan County Hospital in Hoxie, KS, the cash price is $117.00, which matches the facility's median negotiated rate of $79.00 for in-network payers like Celtic Insurance and Blue Cross Blue Shield. While the facility is a Critical Access Hospital owned by the local government, the cash price is notably higher than the median negotiated rate, suggesting that patients with high-deductible plans might find paying out-of-pocket cheaper if their insurance allows exceed the cash price. It is important to note that the facility does not list a specific cash discount percentage, so patients should directly inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final cost.
Pricing transparency reveals that the Medicare benchmark for this service is $15.08, which serves as the objective baseline for evaluating commercial rates. The facility's cash price of $117.00 represents a 5.2x markup compared to the Medicare amount, a figure that is substantially higher than the typical fair pricing range of 120% to 150% of Medicare. Because the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should be cautious of any surprise charges and should always request an itemized bill to verify that all charges align with the negotiated or cash rates listed here.