Blood test, urea nitrogen (BUN, kidney)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $13
- Cash Discount Price: $24
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $8 | 203% |
| Aetna | $11 - $19 | 278% |
| UnitedHealthcare | $13 - $14 | 329% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Community Memorial Healthcare, Inc. in Marysville, KS, the cash price is $24.00, which matches the facility's median negotiated rate of $13.00 when adjusted for the specific payer mix. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, it is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. In this specific case, the cash rate is identical to the median negotiated amount, suggesting that paying out-of-pocket may be the most cost-effective option for patients with high-deductible plans who have not yet met their coverage thresholds. Patients should verify their specific plan's deductible status before scheduling, as using insurance could result in paying the full negotiated rate if the deductible has not been satisfied.
When evaluating the cost against federal benchmarks, the Medicare amount for this code is $3.95, which serves as the objective baseline for pricing transparency. The facility's cash rate of $24.00 represents a significant markup compared to the Medicare benchmark, illustrating the typical range where commercial rates can be 200% to 300% of the Medicare base. To maximize savings, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, since over 80% of hospital bills contain errors, requesting a detailed, itemized statement before payment is crucial to ensure no unbundled codes or services not rendered are included in the total charge.