Blood test, urea nitrogen (BUN, kidney)
Facility: Scott County Hospital
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $49
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 12.41x 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 1241% of the Medicare baseline (a markup of 1141%). 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 |
|---|---|---|
| UnitedHealthcare | $4 - $51 | 101% |
| Blue Cross Blue Shield | $8 | 203% |
| Humana | $23 | 582% |
| Wppa | $32 - $1,200 | 810% |
| Aetna | $49 | 1241% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Scott County Hospital, the facility's negotiated rates range from $4 to $1200 depending on the insurance plan, with a median negotiated amount of $49. This is notably higher than the Medicare benchmark of $3.95, which serves as the objective baseline for fair pricing. While commercial rates often exceed Medicare by significant margins due to administrative costs and contract structures, the data indicates that cash payments are not available for this service. Patients should be aware that while cash-pay options can sometimes be cheaper than insurance negotiated rates, this specific code does not offer a cash price, meaning out-of-pocket costs will align with the insurance allowed amounts rather than a discounted self-pay rate.
To avoid unexpected costs, patients should verify their specific plan's allowed amount before scheduling, as rates vary significantly across payers like UnitedHealthcare and Humana. If a patient receives a bill that exceeds their insurance payment, they may be facing balance billing, though the No Surprises Act generally protects against this for emergency care and non-emergency services at in-network facilities. Furthermore, since over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded statement rather than accepting a summary bill, which can hide unbundled charges or services not rendered. If discrepancies are found, a formal written audit dispute should be sent to the billing supervisor to ensure accuracy before any payment is made.