Blood test, vitamin B12
Facility: Memorial Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $87
- Cash Discount Price: $159
- vs. Medicare Baseline: 5.77x 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 577% of the Medicare baseline (a markup of 477%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $40 | 265% |
| Tricare | $79 | 524% |
| Humana | $79 | 524% |
| Medicare (plans) | $80 | 531% |
| Ambetter / Centene | $87 | 577% |
| Coventry - All Other Plans | $143 | 948% |
| Health Partners Of Kansas - All Plans | $151 | 1001% |
| Preferred Healthcare-All Plans | $151 | 1001% |
| Wppa/Providers Care-All Plans | $222 | 1472% |
Consumer Guidance & Cost Commentary
For this blood test for vitamin B12 at Memorial Hospital in Abilene, KS, the cash price is $159.00, which matches the facility's listed gross charge. While the facility is a Critical Access Hospital with a government ownership structure, the negotiated rates paid by insurance plans range from $40.00 to $222.00, with a median negotiated amount of $87.00. It is important to note that for patients with high-deductible plans, paying the full cash price of $159.00 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 verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative processing fees.
When evaluating the cost against state and county benchmarks, the Medicare benchmark for this service is $15.08, which serves as the objective baseline for pricing. The facility's cash rate of $159.00 represents a significant markup compared to this federal standard, illustrating how commercial rates often differ substantially from the true cost of care. While the median negotiated rate of $87.00 is lower than the cash price, it still exceeds the Medicare benchmark by a wide margin. Patients are advised to request an itemized billing audit to ensure no errors exist, as over 80% of hospital bills contain discrepancies. Furthermore, if a patient chooses to use insurance, they must be aware that balance billing protections under the No Surprises Act may apply, preventing unexpected charges for out-of-network services at this in