Blood test, urea nitrogen (BUN, kidney)
Facility: Mcpherson Hospital
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $24
- Cash Discount Price: $38
- vs. Medicare Baseline: 6.08x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 608% of the Medicare baseline (a markup of 508%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $3 | 76% |
| Humana | $4 | 101% |
| Blue Cross Blue Shield | $4 | 101% |
| Wellcare Mcr Adv - All Plans | $4 | 101% |
| Healthy Blue Mcr Adv | $4 | 101% |
| UnitedHealthcare | $4 - $77 | 101% |
| Va Ccn - All Plans | $4 | 101% |
| Ambetter / Centene | $5 | 127% |
| Wppa - All Plans | $18 - $54 | 456% |
| Central Plains - All Plans | $19 - $58 | 481% |
| Medical Associates - All Plans | $19 - $58 | 481% |
| Christian Health Aid - All Plans | $20 - $62 | 506% |
| Aetna | $21 - $77 | 532% |
| Multiplan - All Plans | $22 - $69 | 557% |
| Health Partners - All Plans | $24 - $73 | 608% |
| First Health - All Plans | $24 - $73 | 608% |
| Cigna | $24 - $73 | 608% |
| Medicaid / KanCare | $25 - $77 | 633% |
| Health Blue Mcaid - All Other Plans | $26 - $79 | 658% |
Consumer Guidance & Cost Commentary
For this blood test service at Mcpherson Hospital, the facility's cash median rate of $38.00 is notably lower than the state average of $51.00, offering a potential savings for patients paying out-of-pocket. While the hospital's negotiated rates with major payers like UnitedHealthcare and Aetna range from $24 to $77, these amounts often exceed the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, provided they verify the specific "self-pay" or "prompt-pay" discounts available to them before scheduling. It is important to note that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, patients should still confirm their plan's status and request a waiver of insurance submission to ensure they are not inadvertently enrolled in a billing cycle that could result in higher charges.
When reviewing your final bill, it is crucial to request an itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Comparing the facility's negotiated rates to the Medicare benchmark of $3.95 reveals a significant markup, as commercial rates often average 200% to 300% of the Medicare amount, whereas fair pricing is typically defined as 120% to 150%. If you receive a bill that appears inflated, you have the right to dispute it in writing with the billing supervisor to correct any inaccuracies. Additionally, since the facility is a voluntary non-profit, you should proactively ask about any prompt-pay discounts that could reduce