Blood test, urea nitrogen (BUN, kidney)
Facility: Clay County Medical Center
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $32
- Cash Discount Price: $34
- vs. Medicare Baseline: 8.10x 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 810% of the Medicare baseline (a markup of 710%). 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 |
|---|---|---|
| Wppa/Providrs Care- All Plans | $32 | 810% |
| Multiplan- All Plans | $32 | 810% |
| Health Partners - All Plans | $32 | 810% |
| Aetna | $32 | 810% |
| UnitedHealthcare | $32 | 810% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Clay County Medical Center in Clay Center, KS, the cash price is $34.00, which matches the facility's median negotiated rate of $32.00 and the state average of $32.00. While the facility is a Critical Access Hospital with government local ownership, the cash price is notably higher than the Medicare benchmark of $3.95, reflecting a markup common in commercial billing. Patients with high-deductible plans may find paying the cash price of $34.00 more cost-effective than using insurance, as the negotiated rate of $32.00 often exceeds the cash price when administrative fees and claim processing costs are factored in. It is advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final amount owed by 20% to 50% if settled upfront.
The facility's pricing structure shows a median paid amount of $32.00 across five payers, including Wppa/Providrs Care, Multiplan, Health Partners, Aetna, and UnitedHealthcare, all of which align with the $32.00 negotiated rate. This consistency suggests a standardized contract approach, though the gross charge of $34.00 serves as the baseline before any discounts are applied. To ensure you are receiving the best possible rate, verify your deductible status before scheduling, as using insurance without meeting your deductible could result in paying the full negotiated amount. Additionally, if you receive an itemized bill, review it carefully for errors or unbundled codes, as over 80% of hospital bills contain inaccuracies that can be corrected through