Blood test, urea nitrogen (BUN, kidney)
Facility: Phillips County Hospital
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $29
- Cash Discount Price: $27
- vs. Medicare Baseline: 7.34x 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 734% of the Medicare baseline (a markup of 634%). 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 - $26 | 203% |
| UnitedHealthcare | $26 - $32 | 658% |
| Health Partners-All Plans | $32 | 810% |
| Medicaid / KanCare | $32 | 810% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Phillips County Hospital in Phillipsburg, KS, the facility's cash price of $27.00 is notably lower than the state average of $32.00, making it a cost-effective option for self-pay patients. While the hospital's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $8 to $32, the cash price often provides a better deal for individuals with high-deductible plans or those without insurance, as the cash rate can be significantly lower than the insurer's allowed amount. Patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate may not be necessary if the insurance company covers the cost after the deductible is met. Additionally, asking the hospital about "self-pay" or "prompt-pay" discounts at the time of registration can sometimes result in further reductions to the bill.
It is important to understand that commercial insurance rates are often inflated by administrative costs and contract structures, which is why the cash price serves as a useful benchmark for fair pricing. The facility's cash rate is also lower than the Medicare benchmark of $3.95 for this service, indicating that the commercial negotiated rates are well above the federal government's calculated cost basis. If you receive a bill from an out-of-network provider or encounter unexpected charges, you may be subject to balance billing, which is largely prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act. To avoid surprise costs, always request an itemized bill before paying, ensuring you can identify any unbundled codes or services not rendered, and dispute any errors in writing rather than accepting summary invoices.