Blood test, urea nitrogen (BUN, kidney)
Facility: Nemaha Valley Community Hospital
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $17
- Cash Discount Price: $29
- vs. Medicare Baseline: 4.30x 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 430% of the Medicare baseline (a markup of 330%). 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 |
|---|---|---|
| Va Ccn - All Plans | $1 | 25% |
| Humana | $14 | 354% |
| Aetna | $14 - $27 | 354% |
| Celtic Comm Exch - All Plans | $15 | 380% |
| Partners Direct Health - All Plans | $17 | 430% |
| Multiplan - All Plans | $29 | 734% |
| Health Partners - All Plans | $30 | 759% |
| Midlands Choice - All Plans | $30 | 759% |
Consumer Guidance & Cost Commentary
For the blood urea nitrogen (BUN) test at Nemaha Valley Community Hospital, the cash median price is $29.00, which is slightly lower than the facility's negotiated rate of $17.00. This cash price is also notably higher than the state of Kansas average for this service, suggesting that paying out-of-pocket may not be the most cost-effective option for patients with high-deductible plans. While commercial payers like Aetna and Humana have negotiated rates ranging from $14 to $27, these amounts often exceed the cash price due to administrative costs and contract structures. Patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting a deductible can result in significantly higher out-of-pocket expenses compared to the cash rate.
To avoid unexpected costs, consumers should request a full itemized bill before finalizing payment, as summary bills often obscure individual line items and potential errors. If a balance bill arises from an out-of-network ancillary service, the No Surprises Act may protect patients from paying the difference between the provider's chargemaster and the insurance allowed amount. Additionally, patients should inquire about prompt-pay discounts, which can reduce the total bill by 20% to 50% if paid upfront, bypassing the administrative overhead associated with insurance claims. Given that Medicare benchmarks this service at $3.95, the commercial negotiated rates reflect a markup typical of the healthcare system, but careful review of the itemized statement and negotiation of payment terms can help minimize financial burden.