CMS Price Transparency Data

Blood test, vitamin B12

Facility: Pender Memorial Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $123
Cash Discount Price: $90
vs. Medicare Baseline: 8.16x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Pender Memorial Hospital is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 8.16x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $90 (597%)

Insurance Median: $123 (816%)

Cash: $90 (597% of Medicare)

Ins. Median: $123 (816% 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 816% of the Medicare baseline (a markup of 716%). 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
Humana	$51 - $171	338%
Blue Cross Blue Shield	$54 - $143	358%
Pace Of The Southern Piedmont	$54	358%
Aetna	$55 - $169	365%
Cigna	$55 - $88	365%
New Hanover Health	$55	365%
Carolina Complete	$56	371%
Nc Department Of Public Safety	$56 - $107	371%
Amerihealth	$57	378%
Wellcare	$57	378%
Ambetter / Centene	$75	497%
Liberty Health	$76	504%
Caresource North Carolina	$80	531%
Plotkin Health	$119	789%
UnitedHealthcare	$145	962%
Medcost	$150 - $167	995%
Employers Choice Network	$193	1280%
Three Rivers Provider Network	$193	1280%

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 $90.
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 Pender Memorial 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.