CMS Price Transparency Data

Blood test, vitamin B12

Facility: Golden Valley Memorial Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $15
  • Cash Discount Price: $74
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Golden Valley Memorial Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 0.99x the Medicare baseline. Located in 1600 N 2Nd St, Clinton, MO.
Cash / Self-Pay
$74

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $74 (491%)
Insurance Median: $15 (99%)
Cash: $74 (491% of Medicare)
Ins. Median: $15 (99% 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.

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
Aetna $15 99%
Home State Health $15 99%
Humana $15 99%
UnitedHealthcare $15 - $26 99%
Ambetter / Centene $18 119%

Consumer Guidance & Cost Commentary

If you are considering paying out-of-pocket for this blood test for vitamin B12 at Golden Valley Memorial Hospital, you should know that the cash median rate is $74, which is significantly lower than the facility's gross charge of $124. For patients with high-deductible plans, this cash price may be more affordable than the negotiated rate of $15, which applies to in-network insurance payers like Aetna, Home State Health, Humana, UnitedHealthcare, and Ambetter/Centene. While the facility is a Government-owned Acute Care Hospital in Clinton, MO, with a rating of 3, the cash option bypasses the administrative costs and markup embedded in the insurance system, potentially saving you money if your insurance allowed amount exceeds $74.

When evaluating the broader financial context, it is important to understand that commercial negotiated rates often exceed cash prices due to multi-layered administrative structures and contract dynamics. Although the data provided does not include specific state or county average figures for comparison, the principle remains that comparing your specific plan's allowed amount directly to the cash rate can reveal significant savings. To ensure you receive the best possible price, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill. Additionally, if you are concerned about potential balance billing or billing errors, always request a full itemized CPT-coded bill before paying, as summary bills can obscure individual charges and lead to unexpected costs.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 N 2Nd St, Clinton, MO 64735
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals