CMS Price Transparency Data

Blood test, vitamin B12

Facility: Progress West Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $70
Cash Discount Price: $64
vs. Medicare Baseline: 4.64x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Progress West Hospital is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 4.64x the Medicare baseline. Located in 2 Progress Point Pkwy, Ofallon, MO.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$70

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: $64 (424%)

Insurance Median: $70 (464%)

Cash: $64 (424% of Medicare)

Ins. Median: $70 (464% 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 464% of the Medicare baseline (a markup of 364%). 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
UnitedHealthcare	$15 - $80	99%
Healthscope Benefits [258]	$18	119%
Cigna	$21 - $32	139%
Aetna	$26 - $80	172%
Allied Benefits [498]	$26 - $80	172%
Consociate [478]	$26	172%
Coresource [497]	$26	172%
Fmh Benefit Service Inc [222]	$26	172%
Mail Handlers [495]	$26	172%
Sarah Bush Lincoln [636]	$26	172%
Apwu Health Plan [216]	$32	212%
Nalc Health Benefit Plan [242]	$32	212%
Priority Health [648]	$32	212%
Blue Cross Blue Shield	$36 - $93	239%
Humana	$42	279%
Healthlink [225]	$52 - $81	345%
Cox Health Systems Insurance Company [220]	$59 - $70	391%
Health Alliance [224]	$59	391%
Hope Trust [806]	$62	411%
Med-Pay [480]	$70 - $80	464%
Unicare [568]	$70 - $81	464%
Beechstreet [551]	$80	531%
Detego Health [868]	$80	531%
First Health Commercial [734]	$80	531%
Health Systems Inc [620]	$80	531%
Healthcare Sol Mercy [609]	$80	531%
Multiplan Commercial [737]	$80	531%
Multiplan [240]	$80	531%
Phcs [244]	$80 - $86	531%
Preferred Health Professionals [561]	$81	537%
Hfn [563]	$86	570%
Medica [661]	$86	570%
Mh Magellan Health Services [270]	$107	710%

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 $64.
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 Progress West 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.