CMS Price Transparency Data

Blood test, vitamin B12

Facility: Clarion Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $23
  • Cash Discount Price: $38
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Clarion Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 1.53x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$38

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $38 (252%)
Insurance Median: $23 (153%)
Cash: $38 (252% of Medicare)
Ins. Median: $23 (153% 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.

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
Medicaid / KanCare $13 86%
Amerihealth $14 - $15 93%
Martin'S Point - Usfhp $14 - $24 93%
Tricare $14 93%
Upmc $14 - $60 93%
Cigna $15 - $34 99%
Highmark $15 - $25 99%
Highmark Community Blue $15 99%
Medicare (plans) $15 99%
UnitedHealthcare $15 99%
Aetna $16 - $61 106%
Devoted Health Plan $16 - $27 106%
Gateway $16 - $25 106%
Geisinger $16 - $17 106%
Pa Health & Wellness $16 106%
The Health Plan $16 - $35 106%
American Health Plan $17 113%
Jefferson Health Plan $17 113%
Highmark - Ind.& Managed Care $23 - $34 153%
Peak Health $35 - $48 232%
Devon $51 338%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals