CMS Price Transparency Data

Blood test, vitamin B12

Facility: Adena Pike Medical Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $54
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 3.58x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Adena Pike Medical Center is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 3.58x the Medicare baseline. Located in 100 Dawn Lane, Waverly, OH.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$54

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: $36 (239%)
Insurance Median: $54 (358%)
Cash: $36 (239% of Medicare)
Ins. Median: $54 (358% 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 358% of the Medicare baseline (a markup of 258%). 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.

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 $17 - $109 113%
Blue Cross Blue Shield $17 - $62 113%
Buckeye Community Health Plan $17 113%
Humana $17 - $68 113%
Medical Mutual Of Ohio $17 - $46 113%
Medigold $17 113%
Molina $17 113%
Care Source $18 119%
Gateway Health $24 159%
Molina Marketplace $28 186%
Care Source Just4Me $31 206%
Sidecar Health $47 312%
Ohio Ppo Connect $50 332%
The Health Plan $50 332%
Cigna $52 345%
Medical Mutual Of Ohio Supermed $54 358%
First Health $56 - $109 371%
Ohio Health Choice $57 378%
Healthsmart $68 451%
Integrated Health Plan $68 451%
Multiplan/Private Healthcare Systems $68 451%
Three Rivers Network $68 451%
UnitedHealthcare $80 531%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Dawn Lane, Waverly, OH 45690
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals