CMS Price Transparency Data

Blood test, vitamin B12

Facility: Southwest General Health Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $66
Cash Discount Price: $123
vs. Medicare Baseline: 4.38x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Southwest General Health Center is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 4.38x the Medicare baseline. Located in 18697 Bagley Road, Middleburg Heights, OH.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$66

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: $123 (816%)

Insurance Median: $66 (438%)

Cash: $123 (816% of Medicare)

Ins. Median: $66 (438% 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 438% of the Medicare baseline (a markup of 338%). 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
Medical Mutual	$6 - $7	40%
Medical Mutual-Ohio	$6	40%
Buckeye	$20 - $66	133%
Molina	$20 - $66	133%
Cigna	$35	232%
Healthsmart	$52	345%
Health Design Plus	$61	405%
Humana	$64 - $66	424%
Amerihealth Caritas	$66	438%
Blue Cross Blue Shield	$66	438%
Caresource	$66	438%
Clarity Health	$66	438%
Healthspan	$66	438%
UnitedHealthcare	$66 - $89	438%
Healthsmart Preferred	$74	491%
Ohio Health Choice Plus	$79	524%
Aetna	$89	590%
Summacare	$89	590%
Coventry	$113	749%
First Health	$113	749%
Ohio Health Choice	$127	842%
Private Healthare Systems	$131	869%

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 $123.
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 Southwest General 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.