Blood test, vitamin D
Facility: Clay County Medical Center
Billing Code: 82306 (CPT)
- CPT Billing Code: 82306
- Insurance Median: $171
- Cash Discount Price: $180
- vs. Medicare Baseline: 5.78x 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 $29.6 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 578% of the Medicare baseline (a markup of 478%). 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 | $167 | 564% |
| Wppa/Providrs Care- All Plans | $167 | 564% |
| UnitedHealthcare | $171 | 578% |
| Multiplan- All Plans | $171 | 578% |
| Health Partners - All Plans | $171 | 578% |
Consumer Guidance & Cost Commentary
For this blood test for vitamin D at Clay County Medical Center in Clay Center, KS, the cash price is $180.00, which matches the facility's cash median. While the facility is a Critical Access Hospital owned by the local government, the negotiated rates for in-network payers like Aetna and UnitedHealthcare are slightly lower at $167.00 to $171.00. It is important to note that for patients with high-deductible plans, paying the full cash price of $180.00 upfront can sometimes be more cost-effective than relying on insurance, as the insurer's allowed amount may exceed the cash rate. Additionally, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the final cost.
When evaluating the value of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's gross charge. The Medicare amount for this code is $29.60, which serves as the objective baseline for fair pricing. The facility's cash rate of $180.00 represents a significant markup over the Medicare rate, a common practice in commercial billing where administrative costs and profit margins are factored in. To ensure you are not overcharged, you should request a detailed, itemized bill that lists every specific CPT code and unit cost, as summary bills often obscure individual charges. If you receive a balance bill for the difference between the provider's full charge and your insurance payment, remember that the No Surprises Act may protect you from these unexpected costs for out-of-network services at in-network facilities.