CMS Price Transparency Data
Blood test, vitamin B12
Facility: Mount Carmel St Ann's
Billing Code: 82607 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 82607
- Insurance Median: $63
- Cash Discount Price: $88
- vs. Medicare Baseline: 4.18x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Mount Carmel St Ann's is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $88. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 4.18x the Medicare baseline. Located in 500 South Cleveland Avenue, Westerville, OH.
Cash / Self-Pay
$88
Average discount available for prompt cash payment at this facility.
Insurance Median
$63
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: $88 (584%)
Insurance Median: $63 (418%)
Cash: $88 (584% of Medicare)
Ins. Median: $63 (418% 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 418% of the Medicare baseline (a markup of 318%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $13 - $16 | 86% |
| Aetna | $14 - $135 | 93% |
| Rural Carrier Health Benefit Plan | $14 | 93% |
| Blue Benefit Administrators Of Massachusetts | $15 | 99% |
| Blue Care Network | $15 | 99% |
| Blue Cross Blue Shield | $15 - $135 | 99% |
| Blue Distinction Transplant | $15 | 99% |
| Blue Shield - Ca | $15 | 99% |
| Blue Shield - Id (Regence) | $15 | 99% |
| Blue Shield - Ny Highmark Northeastern | $15 | 99% |
| Blue Shield - Ny Highmark Western | $15 | 99% |
| Blue Shield - Pa (Highmark) | $15 | 99% |
| Blue Shield - Wa (Regence) | $15 | 99% |
| Hospice Mount Carmel | $15 | 99% |
| Oscar | $15 | 99% |
| The Health Plan | $15 - $89 | 99% |
| UnitedHealthcare | $15 - $69 | 99% |
| Medical Mutual | $27 - $107 | 179% |
| Enterprise Group Planning | $29 | 192% |
| Custom Design Benefits | $32 | 212% |
| Quality Care Partners | $34 | 225% |
| Western & Southern Financial Group | $40 | 265% |
| Geha | $61 - $69 | 405% |
| Gravie Admin Services | $61 | 405% |
| Healthez | $61 | 405% |
| Meritain | $61 | 405% |
| Webtpa | $61 | 405% |
| American Postal Workers Secondary | $62 | 411% |
| Cigna | $62 | 411% |
| Health Partners | $62 | 411% |
| Healthgram | $62 | 411% |
| Mvp | $62 | 411% |
| Priority Health | $62 | 411% |
| Access Health | $63 | 418% |
| Acclaim | $63 | 418% |
| Administrative Concepts | $63 | 418% |
| Allegeant | $63 | 418% |
| Allied Benefit Systems | $63 | 418% |
| American Family | $63 | 418% |
| American Healthcare Alliance | $63 | 418% |
| American National | $63 | 418% |
| American Republic | $63 | 418% |
| Amerihealth | $63 | 418% |
| Aultcare | $63 | 418% |
| Automated Benefit Services | $63 | 418% |
| Auxiant | $63 | 418% |
| Benefit Administrative Systems,Llc | $63 | 418% |
| Boon Chapman | $63 | 418% |
| Cam Administrative Services | $63 | 418% |
| Christian Brother Services | $63 | 418% |
| Christian Brothers Holy Cross | $63 | 418% |
| Claimchoice Adminstrators | $63 | 418% |
| Comprehensive Benefits | $63 | 418% |
| Continental Life Insurance | $63 | 418% |
| Coventry | $63 | 418% |
| Custom Benefit Administrators | $63 | 418% |
| Cypress Benefit Administrators | $63 | 418% |
| Employee Benefit Concepts | $63 | 418% |
| Employee Benefit Management | $63 | 418% |
| Forest County Potawatomi | $63 | 418% |
| Freedom Life Insurance Company | $63 | 418% |
| Group Administrators | $63 | 418% |
| Group Marketing Services | $63 | 418% |
| Group Pension Administrators | $63 | 418% |
| Guardian | $63 | 418% |
| Health America | $63 | 418% |
| Health Choices | $63 | 418% |
| Healthcare Management Admin | $63 | 418% |
| Insight | $63 | 418% |
| Intercare | $63 | 418% |
| Jfp Benefit Management | $63 | 418% |
| Jp Farley Corporation | $63 | 418% |
| Key Benefit Administrator | $63 | 418% |
| Liberty Union Life Assurance Co | $63 | 418% |
| Lucent Health | $63 | 418% |
| Luminare Health | $63 | 418% |
| Magnacare | $63 | 418% |
| Medcost | $63 | 418% |
| Mutual Health Services | $63 | 418% |
| Mutual Of Omaha | $63 | 418% |
| Ncas | $63 | 418% |
| Nippon Life Ins | $63 | 418% |
| Nova | $63 | 418% |
| Painters Union Insurance Fund | $63 | 418% |
| Physicians Mutual | $63 | 418% |
| Plumbers Local 98 Insurance Fund | $63 | 418% |
| Prairie States | $63 | 418% |
| Preferred One | $63 | 418% |
| Primary Physician Care | $63 | 418% |
| Professional Benefit Administrators | $63 | 418% |
| Secureone Preferred United Plans | $63 | 418% |
| Siho Insurance Services | $63 | 418% |
| Sisco Benefits | $63 | 418% |
| The Loomis Company | $63 | 418% |
| Trustmark Small Business Benefits | $63 | 418% |
| U Of M Health Plan | $63 | 418% |
| Unicare | $63 | 418% |
| Unified Group Services | $63 | 418% |
| Us Health And Life | $63 | 418% |
| Valenz | $63 | 418% |
| Varipro | $63 | 418% |
| Wps | $63 | 418% |
| Humana | $69 - $135 | 458% |
| First Health | $71 | 471% |
| Paramount Hmo | $71 | 471% |
| Medben | $81 - $101 | 537% |
| Consociate | $82 | 544% |
| Health Ohio Network | $82 | 544% |
| Caresource | $99 | 656% |
| Healthlink Inc | $101 | 670% |
| Medical Benefits Mutual | $101 | 670% |
| Ohio Health Choice | $101 | 670% |
| Ohio Ppo Connect | $101 | 670% |
| Ameriben | $108 | 716% |
| Luminare Health (Detroit) | $108 | 716% |
| Medi Share | $108 | 716% |
| Multiplan | $108 | 716% |
| Ohiohealthy | $108 | 716% |
| Osu Not Independent Choice | $108 | 716% |
| Phcs | $108 | 716% |
| Philadelphia American Life Insurance | $108 | 716% |
| Twin Valley Psychiatric | $108 | 716% |
| Health Smart | $115 | 763% |
| Bccp | $135 | 895% |
| Medicaid / KanCare | $135 | 895% |
| Optima Health | $135 | 895% |
| Crime Victim Assistance | $632 | 4191% |
| Ohio Safe Program | $632 | 4191% |