Blood test, vitamin B12
Facility: Phillips County Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $78
- Cash Discount Price: $68
- vs. Medicare Baseline: 5.17x 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 517% of the Medicare baseline (a markup of 417%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $57 - $66 | 378% |
| UnitedHealthcare | $62 - $81 | 411% |
| Health Partners-All Plans | $78 - $81 | 517% |
| Medicaid / KanCare | $78 - $81 | 517% |
Consumer Guidance & Cost Commentary
For this blood test for vitamin B12 at Phillips County Hospital, the negotiated rates for in-network insurance plans range from $57 to $81, with a median negotiated amount of $78.00. This facility is a Critical Access Hospital in Phillipsburg, Kansas, and its pricing is notably higher than the state average, which is $68.00. While the cash price is listed at $68.00, patients with high-deductible plans may find it beneficial to pay the cash price directly, as it is lower than the typical insurance negotiated rate. To secure the lowest possible cost, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill.
It is important to understand that commercial insurance rates often exceed cash prices due to the administrative costs and contract structures involved in processing claims. Although the Medicare benchmark for this service is $15.08, commercial rates are expected to be higher, and the facility's negotiated rates reflect this standard market dynamic. If you are using insurance, be aware that the facility may submit a claim to your plan, which could result in balance billing if you are out-of-network or if specific services are not covered under your contract. Always verify your specific plan's allowed amount and deductible status before receiving care to avoid unexpected costs, and never assume that being in-network guarantees the lowest possible price for your procedure.