Blood test, urea nitrogen (BUN, kidney)
Facility: Clara Barton Hospital
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $38
- Cash Discount Price: $29
- 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% |
| 6 Degrees Health - All Plans | $29 | 734% |
| Wppa-All Plans | $34 | 861% |
| Phcs - All Plans | $38 | 962% |
| Aetna | $38 | 962% |
| UnitedHealthcare | $38 | 962% |
| Hlth Partners Of Ks-All Plans | $39 | 987% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Clara Barton Hospital in Hoisington, KS, the facility's cash price of $29.00 is notably lower than the state average of $38.00, making it a potentially cost-effective option for patients with high-deductible plans or those paying out-of-pocket. While the hospital's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare average $38.00, these amounts align with the state median and exceed the cash price, illustrating that commercial insurance contracts often carry a markup above the direct cash rate. Because the cash price is the lowest listed amount, patients should verify if their specific insurance plan has a deductible that would otherwise require them to pay the higher negotiated rate, as paying cash upfront could result in immediate savings.
It is important to note that while the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the Medicare benchmark for this service is only $3.95, which serves as the federal baseline for evaluating pricing fairness. Commercial rates, including the $38.00 negotiated amounts, represent a significant markup over this baseline, a common dynamic in healthcare billing where administrative costs and contract structures inflate the final price paid by insured members. To ensure you are receiving the best possible rate, we recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the bill by bypassing standard insurance billing cycles and administrative overhead.