CMS Price Transparency Data

Blood test, vitamin B12

Facility: UT Health East Texas Carthage Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $308
  • Cash Discount Price: $76
  • vs. Medicare Baseline: 20.42x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at UT Health East Texas Carthage Hospital is $308. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 20.42x the Medicare baseline. Located in 409 Cottage Rd, Carthage, TX.
Cash / Self-Pay
$76

Average discount available for prompt cash payment at this facility.

Insurance Median
$308

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: $76 (504%)
Insurance Median: $308 (2042%)
Cash: $76 (504% of Medicare)
Ins. Median: $308 (2042% 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 2042% of the Medicare baseline (a markup of 1942%). 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
Amerigroup Commercial [5055] $191 1267%
Black Lung [6055] $191 1267%
Healthcare Highways [2210] $191 1267%
Healthscope Benefits [2290] $191 1267%
Lucent Health [6000] $191 1267%
Medicaid / KanCare $191 1267%
Parkland Community Health Plan [6015] $191 1267%
Web Tpa [2115] $191 - $466 1267%
Cigna $426 - $481 2825%
Aetna $466 3090%
Mailhandlers [1595] $466 3090%
Group Pension Admin [1450] $481 3190%
Humana $481 3190%
Phcs [1780] $481 3190%
Tml [1980] $481 3190%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 409 Cottage Rd, Carthage, TX 75633
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals