Blood test, vitamin B12
Facility: William Newton Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $20
- Cash Discount Price: $71
- vs. Medicare Baseline: 1.33x 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.
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 |
|---|---|---|
| Triwest- All Plans | $3 - $46 | 20% |
| UnitedHealthcare | $4 - $119 | 27% |
| Ambetter / Centene | $4 - $132 | 27% |
| Blue Cross Blue Shield | $4 - $55 | 27% |
| Providrs Care Nexus | $6 - $81 | 40% |
| Providrs Care - All Other Plans | $7 - $92 | 46% |
Consumer Guidance & Cost Commentary
For the CPT code 82607, representing a blood test for vitamin B12, William Newton Hospital in Winfield, KS, lists a cash price of $71.00. This cash rate is identical to the facility's median negotiated rate of $71.00, which is notably higher than the state average of $15.00. While commercial payers like UnitedHealthcare and Triwest-All Plans negotiate rates ranging from $3 to $132 depending on the specific plan, patients with high-deductible plans may find paying the full cash price of $71.00 more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the deductible has not been met. It is important to note that while the facility is an in-network Critical Access Hospital, the cash price remains the primary benchmark for self-pay patients.
Patients should be aware that commercial insurance contracts often result in negotiated rates that exceed cash prices due to administrative overhead and multi-layered billing structures. Although the facility's median negotiated rate is $20.00 according to the report data, the specific cash and self-pay rate listed is $71.00, suggesting that the "negotiated" figure in the summary may reflect a different tier or that the cash rate is the definitive self-pay amount. To minimize costs, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as paying in full upfront can sometimes bypass standard insurance processing fees. Additionally, if any unexpected charges arise, patients should request a detailed itemized bill to verify that all services were rendered and to identify any potential errors, as over 80%