CMS Price Transparency Data

Blood test, vitamin B12

Facility: Tomah Memorial Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $36
  • Cash Discount Price: $60
  • vs. Medicare Baseline: 2.39x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Tomah Memorial Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 2.39x the Medicare baseline. Located in 501 Gopher Dr, Tomah, WI.
Cash / Self-Pay
$60

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $60 (398%)
Insurance Median: $36 (239%)
Cash: $60 (398% of Medicare)
Ins. Median: $36 (239% 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 239% of the Medicare baseline (a markup of 139%). 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
Va Ccn - All Plans $16 106%
Blue Cross Blue Shield $17 - $97 113%
Independent Care Mcaid $17 113%
Managed Hlth Mcaid - All Plans $17 113%
Quartz Mcaid $17 113%
Security Hp Mcaid $17 113%
Group Hlth Mcr Adv - All Plans $36 239%
Humana $36 - $97 239%
Independent Care Mcr - All Other Plans $36 239%
Quartz Mcr Adv $36 239%
Security Hp Mcr Adv $36 239%
UnitedHealthcare $36 - $99 239%
Aetna $68 - $89 451%
Cigna $80 - $102 531%
Security Hp Comm - All Other Plans $89 590%
Quartz Comm - All Other Plans $94 623%
The Alliance - All Plans $98 650%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 501 Gopher Dr, Tomah, WI 54660
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals