Blood test, vitamin B12
Facility: Decatur Health
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $81
- Cash Discount Price: $96
- vs. Medicare Baseline: 5.37x 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 537% of the Medicare baseline (a markup of 437%). 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 |
|---|---|---|
| Wppa/Providrs Care- All Plans | $64 | 424% |
| UnitedHealthcare | $65 - $81 | 431% |
| Humana | $66 | 438% |
| Blue Cross Blue Shield | $74 | 491% |
| Aetna | $96 - $107 | 637% |
| Midlands Choice- All Plans | $96 | 637% |
| Medicaid / KanCare | $108 | 716% |
Consumer Guidance & Cost Commentary
For this blood test for vitamin B12 at Decatur Health in Oberlin, Kansas, the negotiated rates paid by insurance companies range from $64 to $108, with a median of $81. These rates are significantly higher than the facility's cash price of $96, which is also higher than the state of Kansas average for this service. While commercial insurance contracts often set a ceiling on what payers will accept, these negotiated amounts frequently exceed what a patient could pay out-of-pocket. If you have a high-deductible plan, paying the cash price of $96 upfront might be more cost-effective than relying on insurance, especially since the facility offers prompt-pay discounts that can further reduce the final bill.
The facility's Medicare benchmark rate for this code is $15.08, which serves as a baseline for evaluating pricing fairness. Commercial negotiated rates are typically much higher than this federal standard due to administrative costs and contract dynamics, but they are still subject to the facility's specific pricing structure. To ensure you are not overcharged, it is important to verify your specific plan's allowed amount before scheduling and to request a self-pay or prompt-pay classification at check-in. If you do not have insurance or wish to minimize administrative fees, paying the cash price directly or utilizing the facility's prompt-pay discount program is often the most transparent and affordable option.