CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84520
Insurance Median: $6
Cash Discount Price: $40
vs. Medicare Baseline: 1.52x Medicare

The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at UMass Memorial Healthalliance Hospitals is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 1.52x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$40

Average discount available for prompt cash payment at this facility.

Insurance Median

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$3.95

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3.95 (100%)

Cash / Self-Pay: $40 (1013%)

Insurance Median: $6 (152%)

Cash: $40 (1013% of Medicare)

Ins. Median: $6 (152% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medicaid / KanCare	$3 - $6	76%
Aetna	$4 - $26	101%
Blue Cross Blue Shield	$4 - $12	101%
Champva [11001]	$4	101%
Cigna	$4 - $15	101%
Commonwealth Care Mcr [10115]	$4	101%
Fallon Mcr Supp [20202]	$4	101%
Grants [20507]	$4 - $40	101%
Harvard Pilgrim Mcr [10106]	$4	101%
Institution [10406]	$4 - $21	101%
Medicare (plans)	$4	101%
Mgb Mcr [10124]	$4	101%
Senior Whole Health [10110]	$4	101%
Tufts Dual [10111]	$4	101%
Tufts Mcr [10112]	$4	101%
Tufts Us Family [11203]	$4	101%
UnitedHealthcare	$4 - $40	101%
Correctional Care [11003]	$5 - $6	127%
Masshealth [20302]	$6	152%
Workers Compensation [20501]	$6	152%
Tufts Connectorcare [10507]	$7	177%
Tufts [11201]	$9	228%
Harvard Pilgrim [10701]	$10 - $12	253%
Wellpoint [11112]	$10	253%
Hne [11108]	$22	557%
First Health Network [11120]	$30	759%
Multiplan [11109]	$30	759%
Fallon Connectorcare [10503]	$35	886%
Connecticare [11105]	$40	1013%
Fallon Carelon Hlth [28]	$40	1013%
Fallon Mcaid Carelon Hlth [29]	$40	1013%
Hsno/Free Care [10801]	$294	7443%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $40.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84520.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UMass Memorial Healthalliance Hospitals is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84520.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.