CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: Southern Ocean Medical Center

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84520
Insurance Median: $41
Cash Discount Price: $4
vs. Medicare Baseline: 10.38x Medicare

The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Southern Ocean Medical Center is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 10.38x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.

Cash / Self-Pay

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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: $4 (101%)

Insurance Median: $41 (1038%)

Cash: $4 (101% of Medicare)

Ins. Median: $41 (1038% 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 1038% of the Medicare baseline (a markup of 938%). 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
Aetna	$4 - $72	101%
Amerigroup	$4	101%
Clover	$4	101%
Seoul Medical Group	$4	101%
United Community/Americhoice	$4	101%
Vaccn	$4	101%
Wellcare	$4	101%
Karna	$5	127%
UnitedHealthcare	$5 - $9	127%
Cigna	$18 - $68	456%
Oxford	$25 - $46	633%
Horizon	$30 - $78	759%
Bergen Risk	$35 - $64	886%
Brighton Health Plan	$38 - $68	962%
Multiplan - PHCS	$40 - $72	1013%
Amerihealth	$41 - $84	1038%
Qualcare	$43 - $77	1089%

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 $4.
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 Southern Ocean Medical Center 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.