CMS Price Transparency Data

Blood test, vitamin B12

Facility: Mainehealth Stephens Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $131
Cash Discount Price: $326
vs. Medicare Baseline: 8.69x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Mainehealth Stephens Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $326. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 8.69x the Medicare baseline. Located in 181 Main Street, Norway, ME.

Cash / Self-Pay

$326

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $326 (2162%)

Insurance Median: $131 (869%)

Cash: $326 (2162% of Medicare)

Ins. Median: $131 (869% 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 869% of the Medicare baseline (a markup of 769%). 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
Aetna	$15 - $298	99%
Blue Cross Blue Shield	$15 - $305	99%
Harvard Pilgrim Healthcare	$15 - $316	99%
Humana	$18 - $127	119%
UnitedHealthcare	$18 - $313	119%
Wellcare	$18 - $132	119%
Community Health Options	$32 - $310	212%
Cigna	$304	2016%
Multiplan	$306	2029%

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 $326.
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 Mainehealth Stephens 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.