CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: St Marys Good Samaritan Hospital

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84520
Insurance Median: $22
Cash Discount Price: $50
vs. Medicare Baseline: 5.57x Medicare

The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at St Marys Good Samaritan Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 5.57x the Medicare baseline. Located in 5401 Lake Oconee Parkway, Greensboro, GA.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$22

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: $50 (1266%)

Insurance Median: $22 (557%)

Cash: $50 (1266% of Medicare)

Ins. Median: $22 (557% 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 557% of the Medicare baseline (a markup of 457%). 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
Amerigroup	$5	127%
Blue Cross Blue Shield	$14 - $58	354%
Aetna	$20 - $64	506%
Ambetter / Centene	$20 - $22	506%
Care Improvement Plus	$20 - $22	506%
Caresource	$20 - $22	506%
Cigna	$20 - $66	506%
Coventry	$20 - $60	506%
Eon Health Plan	$20 - $22	506%
Humana	$20 - $60	506%
Kaiser Permanente	$20 - $22	506%
Molina	$20 - $22	506%
Pruitthealth Premier	$20 - $22	506%
Todays Options Pffs	$20 - $22	506%
Todays Options Ppo	$20 - $22	506%
UnitedHealthcare	$20 - $2,632	506%
Vaccn United	$20 - $22	506%
Wellcare	$20 - $22	506%
First Health	$56 - $60	1418%
Phcs	$56 - $60	1418%
Meritain	$59 - $64	1494%
Multiplan	$63 - $70	1595%
Nova	$63 - $72	1595%
Three Rivers Provider Network	$67 - $72	1696%

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 $50.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84520.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Marys Good Samaritan Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84520.
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.