Blood test, vitamin B12
Facility: Fredonia Regional Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $86
- Cash Discount Price: $96
- vs. Medicare Baseline: 5.70x 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 570% of the Medicare baseline (a markup of 470%). 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 |
|---|---|---|
| UnitedHealthcare | $14 - $86 | 93% |
| Blue Cross Blue Shield | $47 - $57 | 312% |
| Veterans Programs - All Plans | $49 | 325% |
| Aetna | $49 - $86 | 325% |
| Reserve National-All Plans | $86 | 570% |
| Cigna | $86 | 570% |
| Meritain-All Plans | $86 | 570% |
Consumer Guidance & Cost Commentary
For this blood test for vitamin B12 at Fredonia Regional Hospital in Fredonia, KS, the cash price is $96.00, which matches the facility's median negotiated rate of $86.00 and the Medicare benchmark of $15.08. While the facility is a Critical Access Hospital owned by the local government, the cash price is significantly higher than the Medicare rate, illustrating how commercial rates often include administrative markups. For patients with high-deductible plans, paying the full cash price of $96.00 upfront may be more cost-effective than relying on insurance, as the negotiated rate of $86.00 could still exceed the patient's out-of-pocket responsibility if their deductible has not been met. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can further reduce the final cost.
Pricing transparency for this service shows a wide range of allowed amounts across different payers, with rates for UnitedHealthcare spanning from $14 to $86 and Aetna ranging from $49 to $86. This variation highlights the importance of verifying your specific plan's allowed amount before receiving care, as assuming an in-network rate is the lowest possible price can lead to unexpected costs. If you receive a bill that includes charges for services not rendered or unbundled components, you should request a full itemized audit to identify errors, as over 80% of hospital bills contain mistakes that can be corrected. Additionally, under the No Surprises Act, you are protected from balance billing for out-of-network services at in-network facilities, meaning any surprise charges should