CMS Price Transparency Data

Blood test, vitamin B12

Facility: Sanford Clear Lake Medical Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $120
Cash Discount Price: $116
vs. Medicare Baseline: 7.96x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Sanford Clear Lake Medical Center is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 7.96x the Medicare baseline. Located in 701 Third Avenue South, Clear Lake, SD.

Cash / Self-Pay

$116

Average discount available for prompt cash payment at this facility.

Insurance Median

$120

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: $116 (769%)

Insurance Median: $120 (796%)

Cash: $116 (769% of Medicare)

Ins. Median: $120 (796% 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 796% of the Medicare baseline (a markup of 696%). 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
Sanford Health Plan Align	$74	491%
Security Health Plan	$80	531%
Ucare	$80 - $127	531%
Wellmark Sd	$80	531%
Aetna	$81 - $126	537%
Health Partners	$81 - $109	537%
Medicare (plans)	$81	537%
UnitedHealthcare	$81 - $121	537%
Primewest	$82	544%
Sanford Health Plan	$101 - $135	670%
Blue Cross Blue Shield	$119 - $134	789%
Medica	$120 - $128	796%
Wellmark	$125 - $126	829%
Cigna	$130	862%
First Choice Health Network	$130	862%
Healthez	$130	862%
Multiplan	$130	862%

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 $116.
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 Sanford Clear Lake Medical Center 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.