Blood test, urea nitrogen (BUN, kidney)
Facility: Decatur Health
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $13
- Cash Discount Price: $15
- vs. Medicare Baseline: 3.29x 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 329% of the Medicare baseline (a markup of 229%). 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 |
|---|---|---|
| Humana | $10 | 253% |
| Wppa/Providrs Care- All Plans | $10 | 253% |
| UnitedHealthcare | $10 - $13 | 253% |
| Blue Cross Blue Shield | $11 | 278% |
| Aetna | $15 - $16 | 380% |
| Midlands Choice- All Plans | $15 | 380% |
| Medicaid / KanCare | $17 | 430% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Decatur Health in Oberlin, Kansas, the cash median price is $15.00, which is notably lower than the facility's negotiated rates of $13.00 and the Medicare benchmark of $3.95. While the gross charge is $16.00, patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance negotiated rates, which range from $10.00 to $17.00 depending on the payer. It is important to note that while the cash rate is competitive, the facility's negotiated rates are generally higher than the Medicare amount, illustrating how commercial contracts often include administrative costs that inflate the baseline price.
To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. Since the facility is a Critical Access Hospital, it may offer specific financial assistance programs for those who qualify. Additionally, if you have insurance, verify whether your plan covers this service before receiving care, as balance billing could occur if you are treated by an out-of-network provider, though the No Surprises Act protects you from such unexpected charges for emergency services at in-network facilities. Always ask for an itemized bill to ensure all charges are accurate and to identify any potential errors before payment.