Blood test, vitamin B12
Facility: Aurora Medical Center
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $44
- Cash Discount Price: $100
- vs. Medicare Baseline: 2.92x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 292% of the Medicare baseline (a markup of 192%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $12 - $168 | 80% |
| Aurora Caregiver | $15 | 99% |
| Blue Cross Blue Shield | $15 - $170 | 99% |
| Common Ground | $32 - $33 | 212% |
| Centivo | $33 | 219% |
| Aetna | $34 - $165 | 225% |
| Health Payment Systems | $38 | 252% |
| Quartz One | $38 | 252% |
| Healthpartners | $40 - $150 | 265% |
| Hs Technology | $42 | 279% |
| Molina Exchange | $42 | 279% |
| Cigna | $44 - $169 | 292% |
| Everpointe Elite | $44 | 292% |
| Quartz Group | $44 | 292% |
| Wisconsin Physician Service | $49 - $51 | 325% |
| Trilogy | $53 | 351% |
| Health Eos Plus | $120 | 796% |
| Health Eos | $160 | 1061% |
Consumer Guidance & Cost Commentary
For this blood test, vitamin B12 service at Aurora Medical Center in Grafton, WI, the cash median price is $100, which is significantly lower than the facility's gross chargemaster rate of $200. While commercial insurance plans like UnitedHealthcare and Blue Cross Blue Shield may negotiate rates as high as $168 and $170 respectively, patients with high-deductible plans might save money by paying the $100 cash price directly, as the insurance negotiated rates often exceed the cash amount. It is important to note that Medicare allows a much lower payment of $15.08 for this procedure, highlighting that commercial rates can be substantially higher than federal benchmarks.
Patients should be aware that signing consent waivers or paying summary bills without requesting an itemized audit can lead to unexpected balance billing for out-of-network ancillary services, even at in-network facilities. To avoid these surprises, consumers are encouraged to ask about prompt-pay discounts before scheduling, which can further reduce the $100 cash price. Additionally, verifying the specific allowed amount with the insurance carrier is essential, as some plans may have different negotiated rates; for instance, while Common Ground and Centivo have consistent rates of $33, others like Aetna and Healthpartners show wider ranges from $34 to $165 and $40 to $150. Always request a full, CPT-coded itemized bill before finalizing payment to ensure no unbundled charges or services not rendered are included.