CMS Price Transparency Data

Blood test, vitamin B12

Facility: Children's Hospital of Philadelphia

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $192
Cash Discount Price: $457
vs. Medicare Baseline: 12.73x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Children's Hospital of Philadelphia is $192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $457. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 12.73x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$457

Average discount available for prompt cash payment at this facility.

Insurance Median

$192

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: $457 (3031%)

Insurance Median: $192 (1273%)

Cash: $457 (3031% of Medicare)

Ins. Median: $192 (1273% 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 1273% of the Medicare baseline (a markup of 1173%). 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
Geisinger Medical Assistance	$18	119%
Highmark Wholecare	$20	133%
Horizon Nj Health	$54	358%
Medicaid / KanCare	$75	497%
UnitedHealthcare	$76 - $251	504%
Health Partners	$86	570%
Aetna	$108 - $228	716%
Upmc Medical Assistance	$125	829%
Keystone First Chip	$142	942%
Keystone Health Plan East	$144	955%
Blue Cross Blue Shield	$161 - $183	1068%
Geisinger Health Plan Commercial	$201	1333%
Jefferson Health Plans	$216	1432%
Cigna	$228	1512%
Highmark	$228	1512%
Qualcare	$251	1664%
First Health Network	$297	1969%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$366	2427%
Private Health Care Systems	$366	2427%
Choice Care Network	$411	2725%

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 $457.
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 Children's Hospital of Philadelphia 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.