Blood test, urea nitrogen (BUN, kidney)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $18
- Cash Discount Price: $19
- vs. Medicare Baseline: 4.56x 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 456% of the Medicare baseline (a markup of 356%). 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 |
|---|---|---|
| Tricare | $15 | 380% |
| Humana | $17 | 430% |
| Aetna | $18 - $19 | 456% |
| Hpk-All Plans | $18 | 456% |
| UnitedHealthcare | $18 | 456% |
| Medicaid / KanCare | $19 | 481% |
Consumer Guidance & Cost Commentary
For the CPT code 84520, representing a blood test for urea nitrogen (BUN), Medicine Lodge Memorial Hospital in Medicine Lodge, KS, lists a cash median price of $19.00 and a median negotiated rate of $18.00. This cash price is slightly higher than the facility's median paid amount of $18.00, which aligns closely with the state average and is significantly lower than the gross charge of $19.00. While commercial payers like Aetna and UnitedHealthcare have negotiated rates ranging from $18.00 to $19.00, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds this amount. It is important to note that the facility, a Critical Access Hospital owned by a Government Hospital District, does not currently have a published facility rating available in this report.
When evaluating this service, it is crucial to understand that commercial negotiated rates often include administrative overhead, whereas the Medicare amount for this procedure is set at $3.95. The facility's cash price of $19.00 represents a substantial markup compared to the Medicare benchmark, illustrating how commercial rates can differ significantly from federal cost baselines. To ensure you are receiving the most accurate pricing, always request an itemized bill before paying, as summary bills may obscure individual line items. Additionally, inquire about prompt-pay discounts, which can reduce the total cost if you settle the bill upfront, and verify your deductible status to determine if your insurance will cover a portion of the negotiated rate or if you will be responsible for the full amount.