CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: Hospital for Special Surgery

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84520
Insurance Median: $42
Cash Discount Price: $82
vs. Medicare Baseline: 10.63x Medicare

The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Hospital for Special Surgery is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 10.63x the Medicare baseline. Located in 535 East 70Th Street, New York, NY.

Cash / Self-Pay

$82

Average discount available for prompt cash payment at this facility.

Insurance Median

$42

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: $82 (2076%)

Insurance Median: $42 (1063%)

Cash: $82 (2076% of Medicare)

Ins. Median: $42 (1063% 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 1063% of the Medicare baseline (a markup of 963%). 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	$4 - $191	101%
UnitedHealthcare	$5 - $155	127%
Aetna	$9 - $41	228%
Affinity By Molina Health Plan [1005]	$9 - $122	228%
Christian Brothers [1034]	$9 - $41	228%
Connecticare [1039]	$9 - $56	228%
Emblem Health [1043]	$9 - $56	228%
Fidelis Essential [1323]	$9	228%
Harvard Pilgrim [1057]	$9 - $155	228%
Medicare (plans)	$9	228%
Meritain Health [1085]	$9 - $41	228%
Nippon Life [1092]	$9 - $41	228%
Oxford [1096]	$9 - $105	228%
Student Resources [1103]	$9 - $128	228%
Webtpa [1356]	$9 - $41	228%
Geha [1053]	$128	3241%
Apwu [1016]	$129 - $144	3266%
Cigna	$129 - $144	3266%
Nalc [1090]	$129 - $144	3266%
Qualcare [1101]	$129 - $144	3266%
Wellfleet [1361]	$129 - $144	3266%

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 $82.
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 Hospital for Special Surgery 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.