CMS Price Transparency Data
Blood test, urea nitrogen (BUN, kidney)
Facility: Trinity Health Oakland Hospital
Billing Code: 84520 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84520
- Insurance Median: $12
- Cash Discount Price: $23
- vs. Medicare Baseline: 3.04x Medicare
The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Trinity Health Oakland Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 3.04x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$23
Average discount available for prompt cash payment at this facility.
Insurance Median
$12
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: $23 (582%)
Insurance Median: $12 (304%)
Cash: $23 (582% of Medicare)
Ins. Median: $12 (304% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 304% of the Medicare baseline (a markup of 204%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $2 - $4 | 51% |
| Medicaid / KanCare | $2 | 51% |
| U Of M Health Plan | $2 | 51% |
| Aetna | $4 - $17 | 101% |
| Align Senior Care | $4 | 101% |
| Blue Care Network Advantage | $4 | 101% |
| Cca - Zing Health | $4 | 101% |
| Hospice Advantage | $4 | 101% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $4 | 101% |
| Medicare (plans) | $4 | 101% |
| UnitedHealthcare | $4 - $28 | 101% |
| Molina Marketplace | $5 | 127% |
| Wc Accident Fund | $5 - $12 | 127% |
| Wc Advantage | $5 - $12 | 127% |
| Wc Aig | $5 - $12 | 127% |
| Wc Allied | $5 - $12 | 127% |
| Wc Amerisure | $5 - $12 | 127% |
| Wc Amtrust | $5 - $12 | 127% |
| Wc Asu Risk Mgt | $5 - $12 | 127% |
| Wc Berkley Admin | $5 - $12 | 127% |
| Wc Broadspire | $5 - $12 | 127% |
| Wc Bunch & Associates | $5 - $12 | 127% |
| Wc Ccmsi | $5 - $12 | 127% |
| Wc Emc Insurance Company | $5 - $12 | 127% |
| Wc Esis | $5 - $12 | 127% |
| Wc Fcci | $5 - $12 | 127% |
| Wc Federated | $5 - $12 | 127% |
| Wc Gallagher Bassett | $5 - $12 | 127% |
| Wc Genex Care For Ohio | $5 - $12 | 127% |
| Wc Guard Insurance Company | $5 - $12 | 127% |
| Wc Hartford | $5 - $12 | 127% |
| Wc Liberty Mutual | $5 - $12 | 127% |
| Wc Meijers | $5 - $12 | 127% |
| Wc Michigan | $5 - $12 | 127% |
| Wc Mitchell Frankenmuth | $5 - $12 | 127% |
| Wc Pma | $5 - $12 | 127% |
| Wc Sedgwick | $5 - $12 | 127% |
| Wc Sentry | $5 - $12 | 127% |
| Wc Travelers | $5 - $12 | 127% |
| Wc Tristar | $5 - $12 | 127% |
| Wc Walmart | $5 - $12 | 127% |
| Wc Zurich | $5 - $12 | 127% |
| Geha | $6 - $28 | 152% |
| Health Cost Solutions | $6 | 152% |
| Medical Mutual | $6 | 152% |
| Meritain | $6 | 152% |
| Priority Health | $6 | 152% |
| Vitalcore | $6 | 152% |
| Wellpath | $6 | 152% |
| Acs Benefit Services | $7 - $17 | 177% |
| Allied Benefit Systems | $7 - $17 | 177% |
| Claimchoice Adminstrators | $7 - $17 | 177% |
| Consociate | $7 - $17 | 177% |
| Cypress Benefit Administrators | $7 - $17 | 177% |
| Forest County Potawatomi | $7 - $17 | 177% |
| Health Smart | $7 - $17 | 177% |
| Healthgram | $7 - $17 | 177% |
| Healthscope | $7 - $17 | 177% |
| Mclaren Health | $7 - $20 | 177% |
| Secureone Preferred United Plans | $7 - $17 | 177% |
| Sisco Benefits | $7 - $17 | 177% |
| The Health Plan | $7 - $17 | 177% |
| Trustmark Small Business Benefits | $7 - $17 | 177% |
| Unified Group Services | $7 - $17 | 177% |
| Webtpa | $7 - $17 | 177% |
| Carelon Behavioral Health | $8 - $19 | 203% |
| Employee Benefit Logistic | $9 | 228% |
| Magellan Behavioral Health | $9 - $23 | 228% |
| 1199 National Benefit Fund | $10 - $26 | 253% |
| Allied National Global Care | $10 - $26 | 253% |
| Asrm - Reliance Standard Life Insurance | $10 - $26 | 253% |
| Christian Care Ministry | $10 - $26 | 253% |
| Dean Health | $10 - $26 | 253% |
| Fallon Health | $10 - $26 | 253% |
| Family Life Insurance Company | $10 - $26 | 253% |
| Ghc Scw | $10 - $26 | 253% |
| Group Pension Administrators | $10 - $26 | 253% |
| International Benefit Administrators | $10 - $26 | 253% |
| Lifetime Benefit Solutions | $10 - $26 | 253% |
| Manhattan Life | $10 - $26 | 253% |
| Medi Share | $10 - $26 | 253% |
| Multiplan | $10 - $26 | 253% |
| Mvp | $10 - $26 | 253% |
| Pai | $10 - $26 | 253% |
| Pan-American Life | $10 - $26 | 253% |
| Paramount Hmo | $10 - $26 | 253% |
| Phcs | $10 - $26 | 253% |
| Trinity Health Share | $10 - $26 | 253% |
| Access Health | $11 - $28 | 278% |
| Acclaim | $11 - $28 | 278% |
| Administrative Concepts | $11 - $28 | 278% |
| Allegeant | $11 - $28 | 278% |
| Ameriben | $11 - $28 | 278% |
| American Family | $11 - $28 | 278% |
| American Healthcare Alliance | $11 - $28 | 278% |
| American National | $11 - $28 | 278% |
| American Republic | $11 - $28 | 278% |
| Amerihealth | $11 - $28 | 278% |
| Aultcare | $11 - $28 | 278% |
| Automated Benefit Services | $11 - $28 | 278% |
| Auxiant | $11 - $28 | 278% |
| Benefit Administrative Systems,Llc | $11 - $28 | 278% |
| Boon Chapman | $11 - $28 | 278% |
| Cam Administrative Services | $11 - $28 | 278% |
| Christian Brother Services | $11 - $28 | 278% |
| Christian Brothers Holy Cross | $11 - $28 | 278% |
| Cigna | $11 - $28 | 278% |
| Comprehensive Benefits | $11 - $28 | 278% |
| Continental Life Insurance | $11 - $28 | 278% |
| Coventry | $11 - $29 | 278% |
| Custom Benefit Administrators | $11 - $28 | 278% |
| Employee Benefit Concepts | $11 - $28 | 278% |
| Employee Benefit Management | $11 - $28 | 278% |
| Enterprise Group Planning | $11 - $28 | 278% |
| First Health | $11 - $29 | 278% |
| Freedom Life Insurance Company | $11 - $28 | 278% |
| Group Administrators | $11 - $28 | 278% |
| Group Marketing Services | $11 - $28 | 278% |
| Guardian | $11 - $28 | 278% |
| Hap | $11 - $28 | 278% |
| Health America | $11 - $28 | 278% |
| Health Choices | $11 - $28 | 278% |
| Health Partners | $11 - $28 | 278% |
| Healthcare Management Admin | $11 - $28 | 278% |
| Healthez | $11 - $28 | 278% |
| Humana | $11 - $28 | 278% |
| Insight | $11 - $28 | 278% |
| Intercare | $11 - $28 | 278% |
| Jfp Benefit Management | $11 - $28 | 278% |
| Jp Farley Corporation | $11 - $28 | 278% |
| Key Benefit Administrator | $11 - $28 | 278% |
| Liberty Union Life Assurance Co | $11 - $28 | 278% |
| Lucent Health | $11 - $28 | 278% |
| Luminare Health | $11 - $28 | 278% |
| Luminare Health (Detroit) | $11 - $28 | 278% |
| Magnacare | $11 - $28 | 278% |
| Medben | $11 - $28 | 278% |
| Medcost | $11 - $28 | 278% |
| Mutual Health Services | $11 - $28 | 278% |
| Mutual Of Omaha | $11 - $28 | 278% |
| Ncas | $11 - $28 | 278% |
| Nippon Life Ins | $11 - $28 | 278% |
| Nova | $11 - $28 | 278% |
| Painters Union Insurance Fund | $11 - $28 | 278% |
| Physicians Mutual | $11 - $28 | 278% |
| Plumbers Local 98 Insurance Fund | $11 - $28 | 278% |
| Prairie States | $11 - $28 | 278% |
| Preferred One | $11 - $28 | 278% |
| Primary Physician Care | $11 - $28 | 278% |
| Professional Benefit Administrators | $11 - $28 | 278% |
| Siho Insurance Services | $11 - $28 | 278% |
| The Loomis Company | $11 - $28 | 278% |
| Tufts Health Plan | $11 - $28 | 278% |
| Unicare | $11 - $28 | 278% |
| Us Health And Life | $11 - $28 | 278% |
| Valenz | $11 - $28 | 278% |
| Western & Southern Financial Group | $11 - $28 | 278% |
| Wps | $11 - $28 | 278% |
| Asr Health Benefits | $12 | 304% |
| Caresource | $12 | 304% |
| Prime Health Services | $12 - $30 | 304% |
| Varipro | $12 | 304% |
| Three Rivers Provider Network | $14 - $34 | 354% |
| Cmh Detroit Wayne Integrated Health Network | $15 - $38 | 380% |
| Cmh Lenawee County | $15 - $38 | 380% |
| Cmh Livingston County | $15 - $38 | 380% |
| Cmh Misc | $15 - $38 | 380% |
| Cmh Monroe County | $15 - $38 | 380% |
| Cmh Oakland County | $15 - $38 | 380% |
| Cmh Washtenaw County | $15 - $38 | 380% |