Blood test, vitamin B12
Facility: Morris County Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $55
- Cash Discount Price: $85
- vs. Medicare Baseline: 3.65x 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 365% of the Medicare baseline (a markup of 265%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $15 | 99% |
| Aetna | $19 | 126% |
| Va Ccn-All Plans | $21 | 139% |
| Choice Care Mcr Adv-All Plans | $55 | 365% |
| Coventry Mcr | $55 | 365% |
| Blue Cross Blue Shield | $55 - $57 | 365% |
| UnitedHealthcare | $55 - $141 | 365% |
| Cigna | $102 | 676% |
| Multiplan-All Plans | $127 | 842% |
| Coventry Comm-All Other Plans | $127 | 842% |
Consumer Guidance & Cost Commentary
For this blood test for vitamin B12 at Morris County Hospital in Council Grove, Kansas, the cash price is $85.00, which is lower than the facility's negotiated rates of $55.00 to $141.00 depending on the insurance plan. While the facility is a Critical Access Hospital with a government-local ownership, patients with high-deductible plans might find paying the cash price of $85.00 more affordable than their insurance's negotiated rate, which can range up to $141.00. It is important to note that cash-pay rates are often the most transparent baseline, and patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final amount owed.
The data indicates that the facility's cash rate of $85.00 is significantly higher than the state of Kansas average for this service, which is $65.00. However, the facility's negotiated rates vary widely among payers, with some plans like Aetna and Va Ccn paying $19.00, while others like UnitedHealthcare pay up to $141.00. This variation highlights the importance of checking your specific plan's allowed amount before visiting, as the negotiated rate is not a fixed value but depends on your carrier. Additionally, if you receive an itemized bill that includes unexpected charges or broad category summaries, you should request a full line-by-line audit to ensure no errors or unbundled codes are inflating the total, as over 80% of hospital bills contain such discrepancies.