Blood test, vitamin B12
Facility: Regional Medical Center
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $870
- Cash Discount Price: $103
- vs. Medicare Baseline: 57.69x 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 5769% of the Medicare baseline (a markup of 5669%). 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 |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 5769% |
Consumer Guidance & Cost Commentary
If you are a self-pay patient, the most important thing to know is that paying cash directly can often be significantly cheaper than using insurance, especially if your plan has a high deductible or if the negotiated rate exceeds the cash price. For this blood test, vitamin B12 procedure at Regional Medical Center in Manchester, Iowa, the cash median rate is $103, whereas the median negotiated rate paid by in-network payers is $870. This substantial difference means that patients without insurance or those with high deductibles might save hundreds of dollars by paying the cash rate upfront, though they should always ask the facility about self-pay or prompt-pay discounts before scheduling.
The broader pricing context reveals that the facility's cash rate of $103 is much lower than the median negotiated rate of $870, which is the amount commercial insurers like Medical Associates Health Plan - Tri contractually agree to pay. While the facility is a government-owned Critical Access Hospital with a 4-star rating, the data indicates that the cash price is the most direct benchmark for patients seeking to minimize costs. It is crucial to remember that hospitals often issue summary bills that obscure individual prices, so patients should request a full itemized CPT-coded bill to verify charges and avoid paying for services not rendered or unbundled components. Additionally, since the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should never pay a surprise bill without first disputing it with their insurer or requesting a formal audit.