Blood test, vitamin B12
Facility: Girard Medical Center
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $46
- Cash Discount Price: $79
- vs. Medicare Baseline: 3.05x 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 305% of the Medicare baseline (a markup of 205%). 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 | $46 - $229 | 305% |
| Blue Cross Blue Shield | $46 - $57 | 305% |
| Ambetter / Centene | $46 | 305% |
| UnitedHealthcare | $46 - $124 | 305% |
| Medicare (plans) | $46 | 305% |
| Kansas Superior Select-All Plans | $46 | 305% |
| Humana | $46 | 305% |
| Multiplan-All Plans | $121 | 802% |
| Uhhis-All Plans | $124 | 822% |
Consumer Guidance & Cost Commentary
For this blood test for vitamin B12 at Girard Medical Center, the cash median price is $79.00, which is significantly lower than the state average of $131.00. While commercial insurance plans like Aetna and UnitedHealthcare negotiate rates ranging from $46 to $229, these negotiated amounts often exceed the cash price, making self-pay a potentially more affordable option for patients with high deductibles. To secure the lowest possible rate, patients should verify their specific plan's allowed amount before scheduling and ask the facility directly about "self-pay" or "prompt-pay" discounts, which can further reduce the bill by bypassing administrative fees associated with insurance claims.
When evaluating the cost against Medicare, the facility's cash rate of $79.00 is 3.1 times higher than the Medicare benchmark of $15.08, reflecting a substantial markup common in commercial billing. It is important to note that while the facility is a Critical Access Hospital owned by a government authority, the negotiated rates for in-network payers like Blue Cross Blue Shield and Humana (ranging from $46 to $124) are still markedly higher than the cash price. Consumers should avoid relying on summary bills and instead request a detailed itemized statement to ensure no errors exist, as over 80% of hospital bills contain mistakes that could be corrected through a formal audit dispute.