CMS Price Transparency Data

Blood test, vitamin B12

Facility: Boston Children's Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $185
Cash Discount Price: $261
vs. Medicare Baseline: 12.27x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Boston Children's Hospital is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $261. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 12.27x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$261

Average discount available for prompt cash payment at this facility.

Insurance Median

$185

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: $261 (1731%)

Insurance Median: $185 (1227%)

Cash: $261 (1731% of Medicare)

Ins. Median: $185 (1227% 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 1227% of the Medicare baseline (a markup of 1127%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$54 - $172	358%
Unicare	$59	391%
Cdphp	$128 - $222	849%
Harvard Pilgrim	$133 - $176	882%
United	$156 - $218	1034%
Aetna	$157 - $219	1041%
Mgb/Allways	$159 - $193	1054%
Tufts Public Plan	$160 - $161	1061%
United Ri Nj Ny	$164	1088%
Ambetter / Centene	$165	1094%
Carelon Strategies/Bhs	$170	1127%
UnitedHealthcare	$170 - $222	1127%
Carelon/Beacon	$196	1300%
Fallon	$199 - $201	1320%
Health New England	$211	1399%
Cigna	$222 - $236	1472%
Ets/Lifetrac	$222	1472%
Interlink Transplant	$222	1472%
Community Health Options	$235	1558%
Humana	$235	1558%
Coventry/Hcvm/First Health	$240	1592%
Multiplan/Phcs	$240 - $248	1592%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $261.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82607.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Boston Children's Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82607.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.