CMS Price Transparency Data

Blood test, vitamin B12

Facility: St Mary Medical Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $37
  • Cash Discount Price: $86
  • vs. Medicare Baseline: 2.45x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at St Mary Medical Center is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 2.45x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$86

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

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: $86 (570%)
Insurance Median: $37 (245%)
Cash: $86 (570% of Medicare)
Ins. Median: $37 (245% 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 245% of the Medicare baseline (a markup of 145%). 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
Pace-Trinity Health $10 - $17 66%
Align Senior Care $15 99%
Blue Cross Blue Shield $15 - $206 99%
Cigna $15 - $80 99%
Medicaid / KanCare $15 - $31 99%
Medicare (plans) $15 - $27 99%
Aetna $16 - $150 106%
Health America Advantra $18 119%
UnitedHealthcare $21 - $81 139%
Ambetter / Centene $27 179%
Jefferson Health Plan Commercial $27 179%
Oscar $27 179%
Prime Healthcare $27 179%
Homestead Health Plans Woods Center $29 192%
Keystone First $31 206%
Keystone First Chip $31 206%
Group Pension Administrators $34 225%
Reedman Toll $34 225%
Geha $40 - $69 265%
Blue Shield - Pa (Highmark) $41 272%
Amerihealth $80 531%
Blue Shield - Ca $80 531%
Blue Shield - Id (Regence) $80 531%
Blue Shield - Ny Highmark Western $80 531%
Blue Shield - Wa (Regence) $80 531%
Upmc Health Plan $80 531%
Webtpa $80 531%
Meritain $87 - $150 577%
Multiplan $88 - $151 584%
Prime Health Services $88 - $151 584%
Galaxy Health Network $93 - $160 617%
Three Rivers Provider Network $93 - $160 617%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals