CMS Price Transparency Data

Blood test, vitamin B12

Facility: Phelps Memorial Health Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $36
Cash Discount Price: $41
vs. Medicare Baseline: 2.39x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Phelps Memorial Health Center is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 2.39x the Medicare baseline. Located in 1215 Tibbals St, Holdrege, NE.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $41 (272%)

Insurance Median: $36 (239%)

Cash: $41 (272% of Medicare)

Ins. Median: $36 (239% 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 239% of the Medicare baseline (a markup of 139%). 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	$18 - $44	119%
Aetna	$19 - $41	126%
Blue Cross Blue Shield	$19 - $43	126%
Good Samaritan Mcr Adv - All Plans	$19	126%
Medica Mcr Adv	$19	126%
Va Ccn - All Plans	$19	126%
Wellcare Mcr Adv - All Plans	$19	126%
Molina Mcaid - All Plans	$20	133%
Three Rivers - All Plans	$23	153%
6 Degrees Hlth - All Plans	$36	239%
Partners Hlth Alliance - All Plans	$36	239%
Cpi Benefit Group-All Plans	$40	265%
Providrs Care/Wppa - All Plans	$40	265%
Medica-All Other Plans	$42	279%
Provider Network Of American - All Plans	$42	279%
Chi Health Partners - All Plans	$43	285%
First Health - All Plans	$43	285%
Midwest Ntwrk Alliance - All Plans	$43	285%
Ambetter / Centene	$50	332%

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 $41.
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 Phelps Memorial Health Center 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.