CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: Modoc Medical Center

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84520
  • Insurance Median: $74
  • Cash Discount Price: $86
  • vs. Medicare Baseline: 18.73x Medicare
The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Modoc Medical Center is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 18.73x the Medicare baseline. Located in 1111 N Nagle Street, Alturas, CA.
Cash / Self-Pay
$86

Average discount available for prompt cash payment at this facility.

Insurance Median
$74

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: $86 (2177%)
Insurance Median: $74 (1873%)
Cash: $86 (2177% of Medicare)
Ins. Median: $74 (1873% 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 1873% of the Medicare baseline (a markup of 1773%). 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
Integrated Hp Wc $4 101%
Multiplan Wc $4 101%
Ntwrks By Design Wc - All Plans $4 101%
Adv Med Mgmt - All Plans $5 127%
Medi-Cal $5 127%
Medi-Cal 7/1/24 $5 127%
Partnership Hp - All Plans $5 127%
Blue Shield Mcr Adv $46 1165%
Blue Shield Va $46 1165%
UnitedHealthcare $46 - $81 1165%
Healthnet Mcr Adv $49 1241%
Tricare $49 1241%
Blue Cross Blue Shield $70 - $78 1772%
Blue Shield Exch $70 1772%
Blue Shield Comm - All Other Plans $78 1975%
Carelon - All Plans $78 1975%
Aetna $81 2051%
Corvel - All Plans $81 2051%
Coventry/First Health - All Plans $81 2051%
Galaxy Health - All Plans $81 2051%
Healthnet Comm - All Other Plans $81 2051%
Hmn - All Plans $81 2051%
Integrated Hp - All Other Plans $81 2051%
Interplan - All Plans $81 2051%
Multiplan - All Other Plans $81 2051%
Superior Ca Ppo - All Plans $81 2051%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 N Nagle Street, Alturas, CA 96101
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals