CMS Price Transparency Data

Blood test, vitamin B12

Facility: Texas Childrens Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $52
Cash Discount Price: $56
vs. Medicare Baseline: 3.45x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Texas Childrens Hospital is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 3.45x the Medicare baseline. Located in 6621 Fannin Street, Houston, TX.

Cash / Self-Pay

$56

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $56 (371%)

Insurance Median: $52 (345%)

Cash: $56 (371% of Medicare)

Ins. Median: $52 (345% 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 345% of the Medicare baseline (a markup of 245%). 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
Superior Chip	$15 - $16	99%
Driscoll Children'S Health Plan Mcd	$17	113%
First Care Health Plan	$22 - $56	146%
UnitedHealthcare	$22 - $56	146%
Molina Mcd	$24 - $26	159%
Community Health Choice	$26 - $56	172%
Blue Cross Blue Shield	$28 - $55	186%
Community First Health Plan Mcd	$32 - $35	212%
Cook Children'S Health Plan	$32 - $35	212%
Cigna	$46 - $56	305%
Aetna	$52 - $56	345%
Kelseycare	$53 - $57	351%
Healthsmart	$57 - $61	378%
Evolutions Healthcare	$61 - $65	405%
First Health	$71 - $83	471%
Multiplan	$73 - $78	484%
Galaxy Health Network	$77 - $83	511%

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 $56.
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 Texas Childrens Hospital 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.