Blood test, vitamin B12
Facility: Children'S Mercy South
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $33
- Cash Discount Price: $24
- vs. Medicare Baseline: 2.19x 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 219% of the Medicare baseline (a markup of 119%). 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 - $34 | 93% |
| Healthy Blue | $17 - $41 | 113% |
| Medicaid / KanCare | $18 | 119% |
| Blue Cross Blue Shield | $20 - $38 | 133% |
| Cigna | $24 - $35 | 159% |
| Medica | $29 - $30 | 192% |
| Aetna | $29 - $35 | 192% |
| Centivo | $32 - $33 | 212% |
| Orscheln | $32 - $33 | 212% |
| Wppa Providrs Care | $32 - $33 | 212% |
| Nebraska Furniture Mart | $32 - $33 | 212% |
| Wellfit/Centrus | $32 - $33 | 212% |
| Health Midwest Comprehensive Care | $32 - $33 | 212% |
| Quiktrip | $32 - $33 | 212% |
| Humana | $33 - $34 | 219% |
| Coxhealth Network | $36 - $38 | 239% |
| Home State Health | $36 | 239% |
| Coventry Health Care Of Kansas | $36 - $38 | 239% |
| Mercy Health | $37 - $38 | 245% |
| Multiplan | $37 - $39 | 245% |
| American Healthcare Alliance | $42 - $43 | 279% |
| Healthlink | $43 - $45 | 285% |
| National Preferred Provider Network | $44 - $46 | 292% |
Consumer Guidance & Cost Commentary
For the CPT code 82607 (Blood test, vitamin B12) at Children's Mercy South in Overland Park, KS, the facility's cash median rate is $24.00, which is significantly lower than the negotiated rates paid by insurance plans ranging from $14 to $46. While the facility's cash price is well below the state average of $33.00, patients with high-deductible plans may find that paying the cash rate upfront is more cost-effective than relying on insurance, as many commercial payers negotiate rates that exceed the cash price. For instance, UnitedHealthcare plans negotiate a rate between $14 and $34, and Blue Cross Blue Shield plans range from $20 to $38, both of which are higher than the $24.00 cash median. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final cost.
It is important to understand that commercial insurance rates often include administrative overhead and do not reflect the true cost of care, which is better represented by the Medicare benchmark of $15.08. Comparing the facility's cash rate to the Medicare amount reveals a markup of 2.2 times the federal baseline, a standard practice in the healthcare industry where commercial rates typically range from 200% to 300% of Medicare. If a patient receives care from an out-of-network provider or encounters unexpected ancillary services, they may face balance billing for the difference between the provider's chargemaster and the insurance allowed amount, though the No Surprises Act protects patients from such surprise