Blood test, urea nitrogen (BUN, kidney)
Facility: Norton County Hospital
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $12
- Cash Discount Price: $59
- vs. Medicare Baseline: 3.04x 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 304% of the Medicare baseline (a markup of 204%). 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% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Norton County Hospital, the cash price of $59.00 is significantly lower than the facility's negotiated rate of $12.00, which represents the amount Blue Cross Blue Shield pays. This price difference highlights a common billing dynamic where cash-pay options can be more affordable than insurance reimbursement, particularly for patients with high-deductible plans who may face higher out-of-pocket costs if the insurer's negotiated rate exceeds the cash price. While the facility is a Critical Access Hospital in Norton, Kansas, with a government-local ownership structure, patients should verify their specific plan details and ask directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final amount owed.
To ensure you are not overcharged, it is important to understand that commercial rates often include administrative overhead that can inflate the baseline price by 20% to 40% compared to the true cost of care. In this case, the Medicare benchmark amount of $3.95 serves as the objective baseline for evaluating the facility's pricing markup, revealing that the commercial negotiated rate is substantially higher than the federal government's fixed reimbursement rate. If you receive a bill that includes charges for services not rendered or unbundled components, you have the right to request a formal itemized billing audit to identify errors, as over 80% of hospital bills contain inaccuracies that can be corrected through a written dispute sent to the billing supervisor.