CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84520
Insurance Median: $31
Cash Discount Price: $33
vs. Medicare Baseline: 7.85x Medicare

The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Munson Healthcare Otsego Memorial Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 7.85x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$33

Average discount available for prompt cash payment at this facility.

Insurance Median

$31

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: $33 (835%)

Insurance Median: $31 (785%)

Cash: $33 (835% of Medicare)

Ins. Median: $31 (785% 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 785% of the Medicare baseline (a markup of 685%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$1 - $36	25%
UnitedHealthcare	$1 - $46	25%
Mclaren Health Plan	$2 - $48	51%
Meridian	$2	51%
Molina	$2 - $4	51%
Priority Health	$2 - $17	51%
Aetna	$3 - $46	76%
Blue Care Network	$4	101%
Cigna	$4 - $17	101%
Hap (Health Alliance Plan)	$4 - $46	101%
Humana	$4	101%
Medicare (plans)	$4	101%
Michigan Amish Medical Board	$4	101%
Northern Michigan Mennonite Group	$4	101%
Employee Benefit Logistics	$7	177%
Hospice Of Michigan	$22 - $34	557%
Munson Hospice	$26 - $852	658%
Asr Physicians Care Network	$30 - $46	759%
Enterprise Group Planning/Employee Benefit Plan	$30 - $46	759%
Nomi Health	$30 - $46	759%
Cofinity	$31 - $52	785%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$31 - $49	785%
Three Rivers Provider Network	$31 - $49	785%

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 $33.
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 Munson Healthcare Otsego Memorial Hospital 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.