CMS Price Transparency Data

Blood test, vitamin B12

Facility: Pawhuska Hospital, Inc

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $79
Cash Discount Price: $95
vs. Medicare Baseline: 5.24x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Pawhuska Hospital, Inc is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 5.24x the Medicare baseline. Located in 1101 East 15Th Street, Pawhuska, OK.

Cash / Self-Pay

$95

Average discount available for prompt cash payment at this facility.

Insurance Median

$79

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: $95 (630%)

Insurance Median: $79 (524%)

Cash: $95 (630% of Medicare)

Ins. Median: $79 (524% 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 524% of the Medicare baseline (a markup of 424%). 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
UnitedHealthcare	$13 - $177	86%
Healthchoice Ip/Op Only - All Plans	$25	166%
Community Care Comm - All Plans	$38	252%
Blue Cross Blue Shield	$44 - $209	292%
Aetna	$48 - $246	318%
Tricare	$48 - $143	318%
Wellcare Mcr Adv - All Plans	$48 - $143	318%
Humana	$49 - $246	325%
Healthcare Highways - All Plans	$54 - $160	358%
Cigna	$57 - $167	378%
Multiplan - All Plans	$63 - $184	418%
Ambetter / Centene	$73 - $214	484%
Preferred Commchoice Ip/Op Only - All Plans	$75 - $221	497%
Soonerselect Mcaid - All Plans	$84 - $246	557%

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 $95.
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 Pawhuska Hospital, Inc 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.