Blood test, vitamin B12
Facility: Lincoln County Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $57
- Cash Discount Price: $144
- vs. Medicare Baseline: 3.78x 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 378% of the Medicare baseline (a markup of 278%). 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 | 378% |
Consumer Guidance & Cost Commentary
For this vitamin B12 blood test at Lincoln County Hospital, the cash price of $144.00 is significantly lower than the negotiated rate of $57.00 paid by Blue Cross Blue Shield, which is the only payer listed for this service. While the facility is a Critical Access Hospital in Lincoln, KS, and is owned by the local government, the data indicates that the cash price is actually higher than the negotiated amount. This scenario highlights a common billing dynamic where patients with high-deductible plans might find paying out-of-pocket cheaper if the insurance allowed amount exceeds the cash price, though in this specific case, the insurance rate is lower. It is important to note that the facility's ownership structure and location in the 67455 zip code do not alter the fact that the cash price does not represent a discount over the insurer's contracted rate for this procedure.
The Medicare benchmark for this service is $15.08, which serves as the objective baseline for evaluating pricing markups, as commercial rates often exceed this federal standard. Although the data does not provide specific state or county average comparisons for this exact code, the stark difference between the Medicare rate and the cash price illustrates the potential for significant variation in billing. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network emergency care, it does not prevent balance billing for non-emergency services or ancillary tests if the provider is out-of-network. To minimize costs, consumers should request a self-pay or prompt-pay discount before scheduling, as paying upfront can sometimes bypass administrative fees and reduce the final bill, even if the initial cash price listed is higher than the insurer's negotiated rate.