Blood test, urea nitrogen (BUN, kidney)
Facility: F W Huston Medical Center
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $36
- Cash Discount Price: $38
- vs. Medicare Baseline: 9.11x 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 911% of the Medicare baseline (a markup of 811%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $8 | 203% |
| Aetna | $35 | 886% |
| Humana | $37 | 937% |
| Cigna | $40 | 1013% |
Consumer Guidance & Cost Commentary
For this blood test at F W Huston Medical Center in Winchester, KS, the facility's cash price of $38.00 is notably higher than the state average, which sits at $36.00. While the facility offers a negotiated rate of $36.00 for in-network plans, patients with high-deductible or self-pay options might find the cash price more favorable, as it is only slightly above the state average and potentially lower than the final amount their insurance would allow. It is important to note that commercial negotiated rates often include administrative overhead and can exceed cash prices; therefore, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can significantly reduce the final bill.
The Medicare benchmark for this service is $3.95, which serves as a critical baseline for evaluating pricing fairness. The facility's gross charge of $47.00 represents a substantial markup compared to the federal government's cost-based rate, highlighting the difference between the hospital's list price and the true cost of care. Under federal protections like the No Surprises Act, patients receiving care at this in-network Critical Access Hospital are shielded from balance billing for out-of-network ancillary services, such as lab tests, even if the specific provider is out-of-network. To ensure accuracy and avoid unexpected costs, patients should request a detailed, itemized bill rather than accepting a summary invoice, as this allows them to verify that no services were unbundled or charged for without being rendered.