CMS Price Transparency Data

Blood test, vitamin B12

Facility: St Louis Childrens Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $215
Cash Discount Price: $175
vs. Medicare Baseline: 14.26x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at St Louis Childrens Hospital is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $175. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 14.26x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.

Cash / Self-Pay

$175

Average discount available for prompt cash payment at this facility.

Insurance Median

$215

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: $175 (1160%)

Insurance Median: $215 (1426%)

Cash: $175 (1160% of Medicare)

Ins. Median: $215 (1426% 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 1426% of the Medicare baseline (a markup of 1326%). 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 - $230	99%
Humana	$15 - $217	99%
UnitedHealthcare	$15 - $216	99%
Blue Cross Blue Shield	$16 - $247	106%
Cox Health [757]	$16	106%
Essence Healthcare [221]	$16	106%
Medica [662]	$16	106%
Healthlink [225]	$141 - $220	935%
Cigna	$144 - $158	955%
Apwu Health Plan [216]	$158	1048%
Consociate [478]	$158	1048%
Nalc Health Benefit Plan [242]	$158	1048%
Priority Health [648]	$158	1048%
Sarah Bush Lincoln [636]	$158	1048%
Allied Benefits [498]	$169 - $230	1121%
Hope Trust [806]	$169	1121%
Cox Health Systems Insurance Company [220]	$189 - $215	1253%
Med-Pay [480]	$189 - $218	1253%
Unicare [568]	$189 - $220	1253%
Health Alliance [224]	$204	1353%
Healthscope Benefits [258]	$207 - $233	1373%
First Health Commercial [734]	$216	1432%
Beechstreet [551]	$218	1446%
Detego Health [868]	$218	1446%
Health Systems Inc [620]	$218	1446%
Healthcare Sol Mercy [609]	$218	1446%
Multiplan Commercial [737]	$218	1446%
Multiplan [240]	$218	1446%
Phcs [244]	$218 - $233	1446%
Preferred Health Professionals [561]	$220	1459%
Coresource [497]	$230	1525%
Fmh Benefit Service Inc [222]	$230	1525%
Mail Handlers [495]	$230	1525%
Medica [661]	$233	1545%
Hfn [563]	$247	1638%

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 $175.
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 St Louis Childrens 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.