CMS Price Transparency Data

Blood test, vitamin B12

Facility: Pennsylvania Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $144
  • Cash Discount Price: $419
  • vs. Medicare Baseline: 9.55x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Pennsylvania Hospital is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $419. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 9.55x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$419

Average discount available for prompt cash payment at this facility.

Insurance Median
$144

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: $419 (2779%)
Insurance Median: $144 (955%)
Cash: $419 (2779% of Medicare)
Ins. Median: $144 (955% 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 955% of the Medicare baseline (a markup of 855%). 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 - $142 60%
Gateway Health Plan $13 - $19 86%
Medicaid / KanCare $13 - $419 86%
Pa Medical Assistance $13 86%
Blue Cross Blue Shield $15 - $419 99%
Ibc $15 99%
Medicare (plans) $15 99%
Philadelphia Va Medical Center $15 99%
Upmc $15 - $419 99%
Aetna $16 - $419 106%
Clover Health Plan $16 106%
Geisinger Health Plan $16 - $48 106%
Health Partners $16 - $419 106%
Humana $16 - $335 106%
Pa Health And Wellness $16 - $25 106%
Penn Life (Living Independently For Elders) $16 106%
Tricare $16 106%
UnitedHealthcare $16 - $419 106%
Us Family Health Plan $16 106%
Keystone First $17 113%
Keystone Mercy Health Plan $17 113%
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 $71 - $74 471%
Pgm - Regie De L'Assurance Maladie Quebec $96 637%
Preferred Health Care Eliance $109 723%
Pgm - Kuwait Defense $147 - $189 975%
Devon $159 - $189 1054%
Qualcare $159 1054%
Coventry $168 - $214 1114%
Pgm - Chop $168 1114%
Wissahickon Hospice $168 1114%
Healthamerica/Coventry $189 - $205 1253%
Olympus $204 1353%
First Health Global $210 1393%
Urn-Cancer Resource Services $210 1393%
Health Net $251 1664%
Pgm - Royal Embassy Of Saudi Arabia $251 1664%
Pgm - Embassy Of Qatar $272 1804%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $272 1804%
Pgm - Embassy Of The United Emirates/Ipc $293 1943%
Devon Health Services Inc $335 2221%
Health America/Ccn $335 2221%
Intergroup $335 2221%
Pgm - Kuwait Health Division $335 2221%
Pgm - Kuwait Oil $335 2221%
Preferred Care $335 2221%
Commercial Other $419 2779%
Community Behavioral Health $419 2779%
International Pfs $419 2779%
Quest Behavioral Health $419 2779%
United Behavioral Health $419 2779%
Workers Compensation $419 2779%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals