CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: Adventist Health Clearlake

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84520
  • Insurance Median: $16
  • Cash Discount Price: $23
  • vs. Medicare Baseline: 4.05x Medicare
The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Adventist Health Clearlake is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 4.05x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.
Cash / Self-Pay
$23

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $23 (582%)
Insurance Median: $16 (405%)
Cash: $23 (582% of Medicare)
Ins. Median: $16 (405% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 405% of the Medicare baseline (a markup of 305%). 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
Ah Employee Health Plan - All Plans $1 - $93 25%
Aetna $2 - $166 51%
Blue Shield Epn - All Other Plans $2 - $170 51%
Blue Shield Non-Epn $2 - $170 51%
UnitedHealthcare $2 - $185 51%
Western Growers- All Plans $2 - $166 51%
Bc Managed Mcal $3 - $5 76%
Cigna $3 - $200 76%
First Health- All Plans $3 - $178 76%
Foundation- All Plans $3 - $189 76%
Health Mgmt Network- All Plans $3 - $189 76%
Healthnet- All Plans $3 - $182 76%
Humana $3 - $189 76%
Interplan- All Plans $3 - $200 76%
Kaiser- All Other Plans $3 - $200 76%
Medi-Cal $3 - $5 76%
Partnership Mcal - All Plans $3 - $5 76%
Phcs- All Plans $3 - $189 76%
Three Rivers Provider Network- All Plans $3 - $200 76%
Blue Cross Blue Shield $4 - $48 101%
Blue Shield Mcr Adv $4 - $47 101%
Kaiser Mcr Adv $4 - $47 101%
Tricare $4 - $47 101%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15630 18Th Ave - Hwy 53, Clearlake, CA 95422
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals