CMS Price Transparency Data

Blood test, vitamin B12

Facility: Highland Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $15
Cash Discount Price: $71
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Highland Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 0.99x the Medicare baseline. Located in 1000 South Avenue, Rochester, NY.

Cash / Self-Pay

$71

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: $71 (471%)

Insurance Median: $15 (99%)

Cash: $71 (471% 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.

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
Medicaid / KanCare	$13 - $28	86%
Medicare (plans)	$13 - $23	86%
Mvp [2900]	$13 - $14	86%
Amerigroup (Bswny Alternate) [1720]	$14	93%
Cigna	$14	93%
Excellus [2201]	$14 - $17	93%
UnitedHealthcare	$14 - $17	93%
Capital District Physicians Health Plan (Cdphp) [5149]	$15	99%
Martins Point [1205]	$15	99%
Molina Healthcare [5189], Molina Healthcare [1723]	$16 - $28	106%
Humana	$19	126%
Aetna	$20 - $25	133%
Independent Health [5156]	$23	153%
Fidelis [5155]	$28	186%

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 $71.
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 Highland 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.