CMS Price Transparency Data

Blood test, vitamin B12

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $134
  • Cash Discount Price: $73
  • vs. Medicare Baseline: 8.89x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Carilion Stonewall Jackson Hospital is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 8.89x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.
Cash / Self-Pay
$73

Average discount available for prompt cash payment at this facility.

Insurance Median
$134

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: $73 (484%)
Insurance Median: $134 (889%)
Cash: $73 (484% of Medicare)
Ins. Median: $134 (889% 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 889% of the Medicare baseline (a markup of 789%). 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
Blue Cross Blue Shield $16 106%
Sentara Health Plan $16 - $130 106%
Abh of VA (Formerly Coventry) $17 113%
Abh of Wva (Formerly Coventry) $17 113%
Humana $17 113%
UnitedHealthcare $17 - $171 113%
Aetna $106 - $139 703%
Gateway - Tier 3 $115 763%
Vhn - Ultra $130 862%
Connecticare $146 968%
Cigna $167 1107%
Gateway - Tier 2 $167 1107%
Vhn - Plus $167 1107%
Integrated Health Plan $178 1180%
Vhn $178 1180%
Vhn - Link $188 1247%
Beech Street $192 1273%
Gateway - Tier 1 $199 1320%
Vhn - Secondary Payors $199 1320%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Health Circle, Lexington, VA 24450
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals