CMS Price Transparency Data

Blood test, vitamin B12

Facility: Kenmore Mercy Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $15
Cash Discount Price: $21
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Kenmore Mercy Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 0.99x the Medicare baseline. Located in 2950 Elmwood Avenue, Kenmore, NY.

Cash / Self-Pay

$21

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

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: $21 (139%)

Insurance Median: $15 (99%)

Cash: $21 (139% of Medicare)

Ins. Median: $15 (99% 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.

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
UnitedHealthcare	$6 - $16	40%
VA Veterans Affairs [700001]	$6 - $15	40%
Blue Cross Blue Shield	$10 - $29	66%
Iha First Choice [800001]	$12 - $13	80%
Medicare (plans)	$12 - $16	80%
Independent Health [100165]	$12 - $16	80%
Beacon Essential [350122]	$13	86%
Tuscarora Nation [550120]	$13	86%
Univera Healthcare [100169]	$13 - $22	86%
Medicaid / KanCare	$13 - $15	86%
Crime Victims [100176]	$13	86%
Independent Health Essential [100166]	$13	86%
Univera Healthcare Essential [100170]	$13 - $15	86%
Excellus Rochester McD [350117]	$13	86%
Hospice [550001]	$15	99%
Champ VA [700002]	$15	99%
Federal Workers Compensation [500100]	$15 - $26	99%
Catholic Health Life Pace [400005]	$15	99%
Fallon Health [450115]	$15	99%
Covid19 Hrsa [45013]	$15	99%
Tricare	$15	99%
Seneca Nation [450119]	$15	99%
Cigna	$15	99%
Humana	$15 - $16	99%
Fidelis Dual Advantage [450120]	$16	106%
Wellcare [450129]	$16 - $17	106%
Aetna	$16	106%
Wellcare Fidelis Dual [450451]	$16	106%
Fidelis Essential [100163]	$17 - $28	113%
Fidelis Exchange [100164]	$18 - $23	119%
No Fault [114001]	$26	172%
Molina Essential [100167]	$28	186%
Amerigroup [350102]	$29	192%

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 $21.
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 Kenmore Mercy 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.