CMS Price Transparency Data

Blood test, vitamin B12

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $127
Cash Discount Price: $162
vs. Medicare Baseline: 8.42x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at UPMC Children's Hospital of Pittsburgh is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $162. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 8.42x the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$162

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $162 (1074%)

Insurance Median: $127 (842%)

Cash: $162 (1074% of Medicare)

Ins. Median: $127 (842% 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 842% of the Medicare baseline (a markup of 742%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$13 - $148	86%
Health Plan Of Upper Ohio Valley	$15 - $176	99%
Amerihealth Caritas	$16 - $49	106%
Blue Cross Blue Shield	$16 - $125	106%
Cigna	$16 - $148	106%
Upmc Health Plan	$30 - $94	199%
Health Partners Plans (Jefferson Health Plan)	$50	332%
Highmark Wholecare (Prev Gateway)	$52	345%
UnitedHealthcare	$52 - $127	345%
Geisinger	$53 - $121	351%
Pa Health & Wellness	$53	351%
Intergroup	$176 - $230	1167%
Coventry/First Health	$216	1432%
Saudi Armed Forces	$216	1432%
Health Payors Organization	$230	1525%
Multiplan	$230	1525%
National Provider Network	$243	1611%
Private Health Care Systems	$243	1611%

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 $162.
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 UPMC Children's Hospital of Pittsburgh 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.