CMS Price Transparency Data

Blood test, vitamin B12

Facility: Punxsutawney Area Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $15
Cash Discount Price: $48
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Punxsutawney Area Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 0.99x the Medicare baseline. Located in 81 Hillcrest Drive, Punxsutawney, PA.

Cash / Self-Pay

$48

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

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: $48 (318%)

Insurance Median: $15 (99%)

Cash: $48 (318% of Medicare)

Ins. Median: $15 (99% 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.

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	$6 - $50	40%
Cigna	$7 - $74	46%
Highmark Wholecare	$9 - $15	60%
Highmark	$10 - $40	66%
Amerihealth Caritas	$13 - $15	86%
Tricare	$13	86%
Upmc Health Plan	$14 - $67	93%
Aetna	$15 - $33	99%
Geisinger Health Plan	$15 - $17	99%
Humana	$15	99%
United Mine Workers Of America	$15	99%
Ambetter / Centene	$16 - $18	106%
Pa Health And Wellness Commercial	$19 - $30	126%
Geisinger	$21 - $42	139%
Pa Workers Compensation	$124	822%

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 $48.
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 Punxsutawney Area Hospital 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.