Blood test, urea nitrogen (BUN, kidney)
Facility: Children'S Mercy South
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $30
- Cash Discount Price: $22
- vs. Medicare Baseline: 7.59x 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 759% of the Medicare baseline (a markup of 659%). 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 |
|---|---|---|
| Healthy Blue | $4 - $11 | 101% |
| UnitedHealthcare | $4 - $31 | 101% |
| Medicaid / KanCare | $5 | 127% |
| Home State Health | $10 | 253% |
| Blue Cross Blue Shield | $19 - $34 | 481% |
| Cigna | $22 - $32 | 557% |
| Medica | $27 | 684% |
| Aetna | $28 - $31 | 709% |
| Health Midwest Comprehensive Care | $30 | 759% |
| Nebraska Furniture Mart | $30 | 759% |
| Wellfit/Centrus | $30 | 759% |
| Orscheln | $30 | 759% |
| Wppa Providrs Care | $30 | 759% |
| Quiktrip | $30 | 759% |
| Centivo | $30 | 759% |
| Humana | $31 | 785% |
| Mercy Health | $34 | 861% |
| Coventry Health Care Of Kansas | $34 | 861% |
| Coxhealth Network | $34 | 861% |
| Multiplan | $35 | 886% |
| American Healthcare Alliance | $39 | 987% |
| Healthlink | $40 | 1013% |
| National Preferred Provider Network | $41 | 1038% |
Consumer Guidance & Cost Commentary
For the CPT code 84520, representing a blood test for urea nitrogen (BUN), Children's Mercy South in Overland Park, KS, has a cash median price of $22.00, which is significantly lower than the facility's negotiated rates. While the facility's negotiated average is $30.00, commercial payers have agreed to rates ranging from $4 to $41, with most plans falling between $27 and $35. This pricing structure highlights a key billing principle: for patients with high-deductible plans, paying the cash price of $22.00 upfront can be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. Patients should verify their specific plan's deductible status before scheduling, as using insurance to cover a service that costs less out-of-pocket could result in higher out-of-pocket expenses once the deductible is met.
When evaluating the facility's pricing against broader benchmarks, it is important to compare rates to the Medicare amount rather than the gross chargemaster. The Medicare benchmark for this service is $3.95, and the facility's cash rate of $22.00 represents a markup of 7.6 times the Medicare rate. Although commercial negotiated rates typically average 200% to 300% of Medicare, the cash price here is notably lower than the commercial averages. To maximize savings, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the bill by bypassing administrative costs associated with insurance claims processing.