CMS Price Transparency Data

Blood test, vitamin B12

Facility: Harlem Hospital Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $64
Cash Discount Price: Unavailable
vs. Medicare Baseline: 4.24x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Harlem Hospital Center is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 4.24x the Medicare baseline. Located in 506 Lenox Avenue, New York, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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%)

Insurance Median: $64 (424%)

Ins. Median: $64 (424% 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 424% of the Medicare baseline (a markup of 324%). 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	$11 - $44	73%
Healthfirst	$13 - $145	86%
Elderplan	$15	99%
Fidelis	$15 - $145	99%
Magnacare	$18	119%
Oxford	$22	146%
United	$22 - $81	146%
Oscar	$23	153%
Centerlight	$32	212%
Cigna	$37	245%
Wellcare	$38	252%
Carelon	$41 - $64	272%
Emblem	$44 - $87	292%
Blue Cross Blue Shield	$50 - $145	332%
Multiplan	$51	338%
Local 1199	$54	358%
Villagecare Max	$54	358%
Vnsny	$54 - $66	358%
Metroplus	$61 - $145	405%
Amidacare	$64	424%
Senior Whole Health	$64	424%
United Behavioral Health	$64 - $71	424%
Affinity	$66 - $145	438%
Carelon (Amida Care)	$66	438%

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 $X.
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 Harlem Hospital 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.