CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84520
  • Insurance Median: $38
  • Cash Discount Price: $38
  • vs. Medicare Baseline: 9.62x Medicare
The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Saint Joseph Regional Medical Center - Plymouth is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 9.62x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$38

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $38 (962%)
Insurance Median: $38 (962%)
Cash: $38 (962% of Medicare)
Ins. Median: $38 (962% 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 962% of the Medicare baseline (a markup of 862%). 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 $2 - $38 51%
Blue Cross Blue Shield $2 - $8 51%
Medicaid / KanCare $2 - $4 51%
UnitedHealthcare $2 - $38 51%
County Coroner $4 101%
Managed Health Services - Indiana $4 101%
Mdwise $4 101%
Medicare (plans) $4 101%
Meridian Complete $4 101%
Pace-Trinity Health $4 101%
Provider Partners Health Plan Of Indiana $4 101%
Auxiant $6 - $49 152%
Caresource $6 152%
Physicians Health Plan Northern Indiana Health Insurance $6 - $12 152%
Siho Insurance Services $6 152%
St Joseph County Hlth Dpt $6 152%
Key Benefit Administrator $7 - $41 177%
Allied Benefit Systems $8 - $38 203%
Blue Benefit Administrators Of Massachusetts $8 203%
Blue Care Network $8 203%
Blue Distinction Transplant $8 203%
Blue Shield - Ca $8 203%
Blue Shield - Id (Regence) $8 203%
Blue Shield - Ny Highmark Northeastern $8 203%
Blue Shield - Ny Highmark Western $8 203%
Blue Shield - Pa (Highmark) $8 203%
Blue Shield - Wa (Regence) $8 203%
Custom Design Benefits $8 203%
Plain Church Group $16 405%
Notre Dame Athletic Association $32 810%
Wc Notre Dame $32 810%
Luminare Health (Detroit) $34 - $35 861%
Ameriben $35 886%
Asr Health Benefits $38 962%
Christian Brother Services $38 962%
Employee Benefit Management $38 962%
Geha $38 962%
Healthscope $38 962%
Medical Mutual $38 962%
Meritain $38 962%
Preferred One $38 962%
Rural Carrier Health Benefit Plan $38 962%
Student Insurance Cma $38 962%
Webtpa $38 962%
Encore Health $41 1038%
Indiana Criminal Justice Inst $41 1038%
Western & Southern Financial Group $41 1038%
Cigna $42 1063%
Group Administrators $42 1063%
Health Partners $42 1063%
Mvp $42 1063%
Prairie States $42 1063%
Priority Health $42 1063%
Professional Benefit Administrators $42 1063%
Sagamore Health Network $42 - $45 1063%
Sisco Benefits $42 1063%
Unified Group Services $42 1063%
Goshen Preferred Network $45 - $51 1139%
Signature Care $49 1241%
Allied National Global Care $53 1342%
Asrm - Reliance Standard Life Insurance $53 1342%
Avmed Health Plan $53 1342%
Christian Care Ministry $53 1342%
Dean Health $53 1342%
Fallon Health $53 1342%
Family Life Insurance Company $53 1342%
Freedom Life Insurance Company $53 1342%
Ghc Scw $53 1342%
International Benefit Administrators $53 1342%
Lifetime Benefit Solutions $53 1342%
Manhattan Life $53 1342%
Medi Share $53 1342%
Multiplan $53 1342%
Pai $53 1342%
Pan-American Life $53 1342%
Paramount Hmo $53 1342%
Phcs $53 1342%
Philadelphia American Life Insurance $53 1342%
Trinity Health Share $53 1342%
Bankers Life Casualty $59 1494%
Bureau Of Disability $59 1494%
Wc Align Network $59 1494%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1915 Lake Ave, Plymouth, IN 46563
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals