CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: Mercy Hospital Pittsburg, Inc

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84520
  • Insurance Median: $7
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 1.77x Medicare
The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Mercy Hospital Pittsburg, Inc is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 1.77x the Medicare baseline. Located in 1 Mt Carmel Way, Pittsburg, KS.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $36 (911%)
Insurance Median: $7 (177%)
Cash: $36 (911% of Medicare)
Ins. Median: $7 (177% 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.

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
Pace Of The Ozarks Contracted [320518] $4 101%
American Health Advantage Of Ks Mcr Contracted [320508] $4 101%
Dept Of Veteran Affairs Contracted [320106] $4 101%
Medicaid / KanCare $4 - $7 101%
Kindful Hospice [20434] $4 101%
Halo Hcr Inc Hospice [20432] $4 101%
Cross Timbers Hospice [20098] $4 101%
Tricare $4 101%
Halo Hcr Inc Hospice Contracted [320432] $4 101%
Aetna $4 - $48 101%
UnitedHealthcare $4 - $38 101%
Humana $4 101%
Medicare (plans) $4 101%
Elara Caring Aspire Hospice [20433] $4 101%
Kindful Hospice Contracted [320434] $4 101%
Mercy Hospice Okc [20252] $4 101%
Blue Cross Blue Shield $4 - $10 101%
Medica Contracted [320239] $4 101%
Health Choice Contracted [320166] $5 127%
Ambetter / Centene $7 177%
Home State Health Plan Contracted [320187] $7 177%
Providrs Care Network Contracted [320484] $8 203%
Cigna $22 557%
United Medical Resources Contracted [320454] $38 962%
Aither Health Contracted [320449] $45 1139%
Workers Comp [20426] $45 1139%
Yuzu Health Contracted [320521] $45 1139%
Reflect Health Contracted [320492] $45 1139%
Mercy Benefit Admin Contracted [320251] $45 1139%
Auxiant Contracted [320462] $45 1139%
Ebms Contracted [320493] $45 1139%
Healthlink Contracted [320179] $45 1139%
Imagine 360 Contracted [320494] $45 1139%
Edison Health Solutions Contracted [320502] $45 1139%
American Healthcare Alliance Contracted [320020] $45 1139%
First Health Contracted [320128] $48 1215%

Consumer Guidance & Cost Commentary

For the CPT code 84520 (Blood test, urea nitrogen), Mercy Hospital Pittsburg, Inc. lists a gross charge of $56.00, with a cash median price of $36.00. This cash rate is significantly lower than the facility's negotiated rates, which range from $4 to $48 depending on the payer. While the facility is a voluntary non-profit church-owned acute care hospital in Pittsburg, KS, the data provided does not include specific state or county average figures for this procedure, so a direct comparison to regional pricing benchmarks cannot be made. However, patients with high-deductible plans may find the $36.00 cash price more advantageous than their insurance negotiated rates, which can exceed the cash amount due to administrative overhead and contract structures.

The Medicare benchmark for this service is $3.95, indicating that the facility's cash price of $36.00 represents a substantial markup relative to the federal baseline. Commercial negotiated rates for this test vary widely across 36 different payers, with some plans paying as high as $48.00. To optimize costs, patients should verify their specific plan's allowed amount before scheduling, as in-network rates do not always represent the lowest possible price. Additionally, patients should inquire directly with the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed by bypassing standard insurance billing cycles.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Mt Carmel Way, Pittsburg, KS 66762
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals