CMS Price Transparency Data

Blood test, vitamin B12

Facility: Penn Presbyterian Medical Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $218
  • Cash Discount Price: $623
  • vs. Medicare Baseline: 14.46x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Penn Presbyterian Medical Center is $218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $623. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 14.46x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$623

Average discount available for prompt cash payment at this facility.

Insurance Median
$218

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: $623 (4131%)
Insurance Median: $218 (1446%)
Cash: $623 (4131% of Medicare)
Ins. Median: $218 (1446% 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 1446% of the Medicare baseline (a markup of 1346%). 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
Cigna $9 - $197 60%
Medicaid / KanCare $13 - $623 86%
Pa Medical Assistance $13 86%
Blue Cross Blue Shield $15 - $623 99%
Ibc $15 99%
Medicare (plans) $15 99%
Philadelphia Va Medical Center $15 99%
Upmc $15 - $623 99%
Aetna $16 - $623 106%
Clover Health Plan $16 106%
Geisinger Health Plan $16 - $48 106%
Health Partners $16 - $623 106%
Humana $16 - $498 106%
Pa Health And Wellness $16 - $25 106%
Penn Life (Living Independently For Elders) $16 106%
Tricare $16 106%
UnitedHealthcare $16 - $623 106%
Us Family Health Plan $16 106%
Keystone First $17 113%
Keystone Mercy Health Plan $17 - $623 113%
Gateway Health Plan $19 126%
Elap $21 139%
Claims Watcher $24 - $27 159%
Oscar Health Plan $26 172%
Centivo $27 179%
Ibc Commercial Hpn $27 179%
Keystone Hmo Proactive $27 179%
Elap Services $28 186%
Highmark $32 212%
Penn Global Medicine $40 265%
Horizon Nj Health $105 - $110 696%
Pgm - Regie De L'Assurance Maladie Quebec $143 948%
Preferred Health Care Eliance $156 1034%
Pgm - Kuwait Defense $218 - $280 1446%
Devon $237 - $280 1572%
Qualcare $237 1572%
Coventry $249 - $318 1651%
Pgm - Chop $249 1651%
Wissahickon Hospice $249 1651%
Healthamerica/Coventry $280 - $305 1857%
Olympus $295 1956%
First Health Global $312 2069%
Urn-Cancer Resource Services $312 2069%
Health Net $374 2480%
Pgm - Royal Embassy Of Saudi Arabia $374 2480%
Pgm - Embassy Of Qatar $405 2686%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $405 2686%
Pgm - Embassy Of The United Emirates/Ipc $436 2891%
Devon Health Services Inc $498 3302%
Health America/Ccn $498 3302%
Intergroup $498 3302%
Pgm - Kuwait Health Division $498 3302%
Pgm - Kuwait Oil $498 3302%
Preferred Care $498 3302%
Commercial Other $623 4131%
International Pfs $623 4131%
Magellan $623 4131%
Quest Behavioral Health $623 4131%
United Behavioral Health $623 4131%
Workers Compensation $623 4131%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals