CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: Good Samaritan Hospital

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84520
  • Insurance Median: $4
  • Cash Discount Price: $466
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Good Samaritan Hospital is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $466. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 1.01x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.
Cash / Self-Pay
$466

Average discount available for prompt cash payment at this facility.

Insurance Median
$4

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$3.95

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3.95 (100%)
Cash / Self-Pay: $466 (11797%)
Insurance Median: $4 (101%)
Cash: $466 (11797% of Medicare)
Ins. Median: $4 (101% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $3.95 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.

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
Humana $1 - $652 25%
Multiplan $1 - $745 25%
Nx Health Network $1 - $558 25%
Sutter Select $1 - $558 25%
Cigna $2 - $745 51%
First Health $2 - $931 51%
Healthsmart $2 - $745 51%
Intercontinental Corporation $2 - $745 51%
Pha Pacific Health Alliance $2 - $745 51%
Ppo Next $2 - $745 51%
Aetna $4 - $20 101%
Affinity Medical Group $4 101%
Alignment Health Plan $4 101%
Blue Cross Blue Shield $4 - $21 101%
Blue Shield $4 - $7 101%
Care1St Health Plan $4 101%
Central Health Plan $4 101%
Clever Care Of Golden State $4 101%
Easy Choice Health Plan $4 101%
Managed Health Network $4 101%
On Lok Senior Health $4 101%
Palo Alto Medical $4 - $5 101%
Physicians Medical Group $4 101%
Santa Clara Family Health Plan $4 - $177 101%
Scan Health Plan $4 101%
Triwest Healthcare Alliance $4 101%
United $4 - $237 101%
University Healthcare $4 101%
Vitality Health Plan $4 101%
Affinity Medical Group Comm $5 127%
Corvel Corporation $5 127%
Health Net $5 - $217 127%
Canopy $7 177%
Bright Health $8 203%
Medcare Partners $140 3544%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2425 Samaritan Drive, San Jose, CA 95124
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals