Blood test, urea nitrogen (BUN, kidney)
Facility: Sheridan County Hospital
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $19
- Cash Discount Price: $31
- vs. Medicare Baseline: 4.81x 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 481% of the Medicare baseline (a markup of 381%). 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 | $12 | 304% |
| Celtic Insurance | $19 | 481% |
| UnitedHealthcare | $29 | 734% |
Consumer Guidance & Cost Commentary
For the CPT code 84520, representing a blood test for urea nitrogen (BUN), Sheridan County Hospital in Hoxie, KS, lists a cash price of $31.00. This cash rate is identical to the facility's negotiated rate of $19.00 and the Medicare benchmark of $3.95, with a 4.8x markup relative to Medicare. While the facility is a Critical Access Hospital owned by the local government, patients should note that commercial insurance carriers like Blue Cross Blue Shield, Celtic Insurance, and UnitedHealthcare have negotiated rates ranging from $12 to $29 depending on the specific plan. Because the cash price matches the negotiated rate, paying out-of-pocket may not offer a financial advantage unless the patient's specific insurance plan has a negotiated rate higher than $31.00, which would make the cash option cheaper.
To ensure you receive the most accurate pricing, it is essential to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, patients should inquire about prompt-pay discounts, which can reduce the total cost by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims processing. If you encounter a balance bill for the difference between the chargemaster and your insurance allowed amount, remember that the No Surprises Act protects you from such charges for emergency care and non-emergency services at in-network facilities. Always verify your deductible status and request a self-pay classification prior to scheduling to avoid unexpected billing surprises.