Blood test, urea nitrogen (BUN, kidney)
Facility: Ellsworth County Medical Center
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $31
- Cash Discount Price: $34
- vs. Medicare Baseline: 7.85x 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 785% of the Medicare baseline (a markup of 685%). 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 | $16 - $32 | 405% |
| Va Ccn-All Plans | $16 | 405% |
| Healthy Blue Mcr Adv | $16 | 405% |
| Triwest -All Plans | $16 | 405% |
| UnitedHealthcare | $22 - $34 | 557% |
| Aetna | $31 | 785% |
| First Health - All Plans | $31 | 785% |
| Cigna | $32 | 810% |
| Healthy Blue Mcaid- All Other Plans | $34 | 861% |
| Coventry Mcaid-All Plans | $34 | 861% |
| Medicaid / KanCare | $34 | 861% |
| Providers Care-Wppa-All Plans | $51 | 1291% |
Consumer Guidance & Cost Commentary
For the blood test for urea nitrogen (BUN) at Ellsworth County Medical Center in Ellsworth, Kansas, the cash price is $34.00, which matches the facility's negotiated rate and the state average. This service is billed under CPT code 84520, and while the facility is a Critical Access Hospital with a proprietary ownership structure, the cash price aligns closely with the national average for this procedure. Patients with high-deductible plans may find paying the full cash price upfront more cost-effective than using insurance, as the negotiated rates for various payers range from $8 to $51, often exceeding the cash amount. To maximize savings, individuals should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within a short window, bypassing the administrative costs associated with insurance claims processing.
When comparing this facility's pricing to Medicare benchmarks, the Medicare amount for this code is $3.95, indicating that the cash price represents a significant markup relative to the federal baseline. While commercial negotiated rates typically average 200% to 300% of Medicare rates, the cash price here sits at $34.00, which is notably higher than the $16.00 median paid by insurers across the 13 identified payers. It is important to note that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though patients should verify their network status before scheduling to avoid unexpected out-of-network charges. If a patient receives an itemized bill, they should