Blood test, vitamin B12
Facility: Trego County Lemke Memorial Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $76
- Cash Discount Price: $76
- vs. Medicare Baseline: 5.04x 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 504% of the Medicare baseline (a markup of 404%). 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 |
|---|---|---|
| Va Ccn - All Plans | $13 | 86% |
| Humana | $44 | 292% |
| Tricare | $47 | 312% |
| Medicaid / KanCare | $55 - $89 | 365% |
| UnitedHealthcare | $55 - $89 | 365% |
| Aetna | $55 - $80 | 365% |
| Ambetter / Centene | $61 | 405% |
| Blue Cross Blue Shield | $79 | 524% |
| Health Partners - All Plans | $85 | 564% |
| Healthy Blue Mcaid - All Plans | $89 | 590% |
Consumer Guidance & Cost Commentary
For the CPT code 82607, representing a blood test for vitamin B12, the facility's cash median price of $76.00 is notably lower than the gross charge of $89.00. While the negotiated rates for in-network payers such as Humana and Tricare average $44 to $47, and Medicaid/KanCare ranges from $55 to $89, the cash price remains the most affordable option at $76.00. This aligns with the principle that cash-pay can sometimes be cheaper for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price, though in this specific case, the cash rate is already the lowest available figure. Patients should verify their specific plan's allowed amount, as some commercial payers may negotiate rates that approach or exceed the cash price depending on their deductible status.
It is important to note that the Medicare amount for this service is $15.08, which serves as the objective baseline for evaluating pricing markups. Commercial negotiated rates often average 200% to 300% of Medicare, while fair pricing is typically defined as 120% to 150% of Medicare; however, the cash price here is significantly lower than the Medicare benchmark, making it the most cost-effective option for self-pay. To ensure you receive the best possible rate, you should explicitly ask the hospital for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final cost. Additionally, if you receive a summary bill, request a full itemized CPT-coded statement to identify any errors or unbundled charges