Blood test, urea nitrogen (BUN, kidney)
Facility: Fredonia Regional Hospital
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $33
- Cash Discount Price: $36
- vs. Medicare Baseline: 8.35x 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 835% of the Medicare baseline (a markup of 735%). 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 | $1 - $33 | 25% |
| Blue Cross Blue Shield | $8 - $18 | 203% |
| Veterans Programs - All Plans | $19 | 481% |
| Aetna | $19 - $33 | 481% |
| Meritain-All Plans | $33 | 835% |
| Reserve National-All Plans | $33 | 835% |
| Cigna | $33 | 835% |
Consumer Guidance & Cost Commentary
For this blood test service at Fredonia Regional Hospital, the cash price of $36.00 is identical to the facility's median negotiated rate of $33.00 and the state average of $36.00. While the facility is a Critical Access Hospital in Kansas, the cash price matches the state average exactly, meaning patients paying out-of-pocket are not paying a premium above the regional norm. However, it is important to note that commercial insurance carriers often pay negotiated rates higher than the cash price due to administrative overhead and contract structures. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $36.00 upfront could be more cost-effective than relying on insurance, which may result in a higher allowed amount before the deductible is satisfied.
The Medicare benchmark for this procedure is significantly lower at $3.95, highlighting the substantial markup inherent in commercial billing. The facility's median negotiated rate of $33.00 is 8.4 times the Medicare amount, which is consistent with the typical range where commercial rates exceed Medicare benchmarks by 200% to 300%. To minimize costs, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid in full before or shortly after the service. Additionally, since over 80% of hospital bills contain errors, patients should request a detailed, itemized statement to ensure no unbundled codes or services not rendered are included before finalizing payment.