CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: Golden Valley Memorial Hospital

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84520
  • Insurance Median: $4
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Golden Valley Memorial Hospital is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 1.01x the Medicare baseline. Located in 1600 N 2Nd St, Clinton, MO.
Cash / Self-Pay
$32

Average discount available for prompt cash payment at this facility.

Insurance Median
$4

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: $32 (810%)
Insurance Median: $4 (101%)
Cash: $32 (810% of Medicare)
Ins. Median: $4 (101% 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.

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
Aetna $4 101%
Home State Health $4 101%
Humana $4 101%
UnitedHealthcare $4 - $7 101%
Ambetter / Centene $5 127%

Consumer Guidance & Cost Commentary

For this Blood test, urea nitrogen (BUN, kidney) procedure at Golden Valley Memorial Hospital, the cash median price of $32 is significantly lower than the facility's gross charge of $54 and the state average of $32. While the cash rate matches the state average exactly, it is notably cheaper than the Medicare benchmark of $3.95, which serves as the federal cost baseline for this service. Patients with high-deductible plans or those without insurance may find the cash price of $32 more favorable than the negotiated rates charged by insurance carriers, which range from $4 to $7 depending on the plan.

The facility offers a median negotiated rate of $4 to in-network payers such as Aetna, Home State Health, Humana, and Ambetter / Centene, though UnitedHealthcare plans show a wider range between $4 and $7. It is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures, meaning the $4 negotiated rate is still higher than the $32 cash median in this specific dataset, though individual plan limits may vary. To potentially lower costs further, patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing insurance billing cycles. Additionally, if a bill is received, consumers should request a full itemized CPT-coded statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors that can be disputed in writing to prevent balance billing or double-charging.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 N 2Nd St, Clinton, MO 64735
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals