Blood test, urea nitrogen (BUN, kidney)
Facility: Holton Community Hospital
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $38
- Cash Discount Price: $34
- vs. Medicare Baseline: 9.62x 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 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.
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% |
| Humana | $24 | 608% |
| Aetna | $24 - $46 | 608% |
| UnitedHealthcare | $24 - $46 | 608% |
| Kansas Superior Select - All Plans | $25 | 633% |
| Preferred Health Freedom | $38 | 962% |
| Preferred Health Fn Select - All Other Plans | $38 | 962% |
| Preferred Health Professionals | $38 | 962% |
| Wppa Providers - All Plans | $43 | 1089% |
| Medicaid / KanCare | $46 | 1165% |
Consumer Guidance & Cost Commentary
For the blood test for urea nitrogen (BUN) at Holton Community Hospital, the facility's cash median price is $34.00, which is lower than the state average of $38.00. While the hospital's negotiated rates with major payers like Aetna and UnitedHealthcare range from $24.00 to $46.00, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $34.00. It is important to note that the facility's cash rate is also significantly higher than the Medicare benchmark of $3.95, reflecting the standard markup for commercial services. To potentially lower costs further, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront.
Although the facility is an in-network Critical Access Hospital in Kansas, patients must remain vigilant regarding balance billing and billing accuracy. The No Surprises Act generally protects patients from unexpected out-of-network balance bills for emergency care and non-emergency services at in-network facilities, but patients should still request an itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included. Since over 80% of hospital bills contain errors, reviewing the detailed line items before paying is essential to avoid overcharges. Additionally, while the facility is a voluntary non-profit, the negotiated rates vary widely across different insurance plans, so verifying your specific allowed amount before scheduling the test can help ensure you are not paying more than necessary.