CMS Price Transparency Data

Blood test, vitamin B12

Facility: Crouse Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $25
Cash Discount Price: $45
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Crouse Hospital is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 1.66x the Medicare baseline. Located in 736 Irving Avenue, Syracuse, NY.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$25

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: $45 (298%)

Insurance Median: $25 (166%)

Cash: $45 (298% of Medicare)

Ins. Median: $25 (166% 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
Excellus	$16 - $33	106%
Aetna	$18 - $32	119%
Brighton Healthplan	$18 - $25	119%
Cdphp	$18	119%
Emblemhealth	$18	119%
Fidelis	$18 - $57	119%
Humana	$18	119%
Martins Point	$18	119%
Mvp	$18 - $57	119%
Nascentia	$18	119%
UnitedHealthcare	$18 - $30	119%
Mycompass	$19 - $26	126%
Wellcare	$19 - $31	126%
Healthfirst Health Plan	$25 - $28	166%
Molina	$25 - $57	166%
Emblem Health	$41	272%

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 $45.
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 Crouse 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.