Blood test, vitamin B12
Facility: Community Memorial Healthcare, Inc.
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $38
- Cash Discount Price: $65
- vs. Medicare Baseline: 2.52x 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 252% of the Medicare baseline (a markup of 152%). 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 |
|---|---|---|
| Aetna | $23 - $59 | 153% |
| UnitedHealthcare | $29 - $45 | 192% |
| Blue Cross Blue Shield | $57 | 378% |
Consumer Guidance & Cost Commentary
For this vitamin B12 blood test at Community Memorial Healthcare in Marysville, KS, the facility's cash price of $65.00 matches the cash median for this procedure in the state. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should note that commercial insurance rates often exceed cash prices due to administrative overhead and contract dynamics. The median negotiated rate for this service is $38.00, which is lower than the cash price, but this rate is subject to your specific plan's deductible and copay requirements. If you have a high-deductible plan where you have not yet met your out-of-pocket maximum, paying the cash price of $65.00 upfront could result in a lower total cost than using insurance, which might trigger a higher allowed amount or require you to pay the full negotiated rate before your deductible is satisfied.
When evaluating the cost relative to Medicare, the facility's cash rate is 2.5 times the Medicare benchmark of $15.08. It is important to compare rates against the Medicare baseline rather than the hospital's gross chargemaster to understand the true markup, as commercial rates can average 200% to 300% of Medicare, whereas fair pricing is typically defined as 120% to 150%. Before scheduling, you should verify your specific insurance status and ask the facility directly about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid in full within a short window. Additionally, ensure you request an itemized bill to review every line item for accuracy, as over 80% of hospital bills