CMS Price Transparency Data

Blood test, vitamin B12

Facility: Margaretville Memorial Hospital

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82607
Insurance Median: $106
Cash Discount Price: $241
vs. Medicare Baseline: 7.03x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Margaretville Memorial Hospital is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $241. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 7.03x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$241

Average discount available for prompt cash payment at this facility.

Insurance Median

$106

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: $241 (1598%)

Insurance Median: $106 (703%)

Cash: $241 (1598% of Medicare)

Ins. Median: $106 (703% 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 703% of the Medicare baseline (a markup of 603%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$23 - $106	153%
Oxford	$23	153%
Aetna	$41 - $241	272%
Mvp	$64	424%
Mvp Hmo/Ppo	$76	504%
Blue Cross Blue Shield	$89 - $118	590%
Mvp Gold (McR)	$106	703%
Hamaspik (McR)	$106	703%
Medicare (plans)	$106 - $159	703%
Affinity By Molina McR	$111	736%
Cdphp	$117	776%
Self-Pay	$127	842%
Emblem Ghi/Hip Ppo/Cbp	$149	988%
Mvp Exchange	$157	1041%
Emblem Select Care (Exchange)	$164	1088%
Magnacare Standard	$169	1121%
Oxford Exchange	$169	1121%
Todays Options	$175	1160%
Emblem Ghi/Hip Hmo/Epo/Pos	$193	1280%
Multiplan	$198	1313%
First Health	$217	1439%
Magnacare Preferred	$952	6313%

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 $241.
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 Margaretville Memorial 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.