CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84520
  • Insurance Median: $86
  • Cash Discount Price: $78
  • vs. Medicare Baseline: 21.77x Medicare
The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at HSHS St Elizabeth's Hospital is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 21.77x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$78

Average discount available for prompt cash payment at this facility.

Insurance Median
$86

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: $78 (1975%)
Insurance Median: $86 (2177%)
Cash: $78 (1975% of Medicare)
Ins. Median: $86 (2177% 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 2177% of the Medicare baseline (a markup of 2077%). 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
Aetna $4 - $76 101%
Blue Cross Blue Shield $4 - $108 101%
Clear Spring Health Of Illinois $4 101%
Health Alliance Medical Plans $4 - $92 101%
Health Partners $4 101%
Humana $4 101%
Illinois Breast And Cervical Cancer Program $4 101%
Meridian Health Plan $4 101%
Molina Healthcare $4 101%
Sae Hospice $4 101%
UnitedHealthcare $4 - $108 101%
Celtic Insurance Company $8 203%
Naphcare $9 228%
Claim Doc $10 253%
Hopetrust $10 253%
Amish Community $30 759%
Wellfirst $70 1772%
First Health $80 2025%
Cigna $85 - $108 2152%
Healthlink $86 - $108 2177%
Caterpillar, Inc. $87 2203%
Consociate Group $95 2405%
Choicecare $97 2456%
Healthcare Finest Network (Hfn) $97 2456%
Multiplan/Phcs $97 2456%
Provider Network Of America $97 2456%
City Of Springfield $108 2734%
Current Health Solutions $108 2734%
Healthscope $108 2734%
Interplan $108 2734%
Live360 $108 2734%
Wexford $108 2734%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals