CMS Price Transparency Data

Blood test, vitamin B12

Facility: St Claire Regional Medical Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $49
  • Cash Discount Price: $53
  • vs. Medicare Baseline: 3.25x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at St Claire Regional Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 3.25x the Medicare baseline. Located in 222 Medical Circle, Morehead, KY.
Cash / Self-Pay
$53

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$15.08

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $15.08 (100%)
Cash / Self-Pay: $53 (351%)
Insurance Median: $49 (325%)
Cash: $53 (351% of Medicare)
Ins. Median: $49 (325% of 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 325% of the Medicare baseline (a markup of 225%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $10 - $17 66%
Blue Cross Blue Shield $15 - $52 99%
Caresource Mcr Adv $15 99%
Humana $15 - $50 99%
Caresource Just4Me - All Other Plans $20 133%
Healthlink - All Plans $47 - $50 312%
Wellcare Comm - All Other Plans $58 - $61 385%
Aetna $68 - $72 451%
Wellcare Mcaid $68 - $72 451%
Beacon Bh - All Plans $71 - $76 471%
Ky Health Co-Op - All Plans $88 - $94 584%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 222 Medical Circle, Morehead, KY 40351
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Federal
  • Hospital Type: Acute Care Hospitals