CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: Saint Alphonsus Medical Center Ontario

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84520
  • Insurance Median: $11
  • Cash Discount Price: $25
  • vs. Medicare Baseline: 2.78x Medicare
The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Saint Alphonsus Medical Center Ontario is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 2.78x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$25

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $25 (633%)
Insurance Median: $11 (278%)
Cash: $25 (633% of Medicare)
Ins. Median: $11 (278% 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 278% of the Medicare baseline (a markup of 178%). 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
Medicaid / KanCare $3 - $11 76%
Aetna $4 - $36 101%
American Health Advantage Of Idaho $4 101%
Blue Cross Blue Shield $4 - $32 101%
Healthnet $4 101%
Medicare (plans) $4 101%
UnitedHealthcare $4 - $36 101%
Blue Benefit Administrators Of Massachusetts $7 177%
Blue Care Network $7 177%
Blue Distinction Transplant $7 177%
Blue Shield - Ca $7 177%
Blue Shield - Id (Regence) $7 177%
Blue Shield - Ny Highmark Northeastern $7 177%
Blue Shield - Ny Highmark Western $7 177%
Blue Shield - Pa (Highmark) $7 177%
Blue Shield - Wa (Regence) $7 177%
Healthcare Management Admin $7 177%
Moda Health $8 - $37 203%
Webtpa $10 - $34 253%
Ada County Jail Inmate Ins $11 278%
Ambetter / Centene $11 278%
Amish Mennonite $11 278%
Bcccp-Michigan $11 278%
Bccp $11 278%
Bmc Healthnet $11 278%
Breast Grant-Connecticut $11 278%
California Health And Wellness $11 278%
Cardinal Innovations Lme $11 278%
Care Oregon Ohp $11 278%
Cencal Health Plan $11 278%
Cenpatico $11 278%
Centurion Of Idaho $11 278%
Chhuny $11 278%
Childrens Comm Health Plan $11 278%
Childrens Medical Services Title 19 $11 278%
Cigna $11 - $36 278%
Community Benefit Health $11 278%
Community Care Behavorial Health $11 278%
Community Health Choice $11 278%
Covid19 Hrsa Uninsured Testing And Treatment Fund $11 278%
Dean Wi Badgercare $11 278%
Delaware First Health $11 278%
Delta Dental Nj $11 278%
Dph Tb Program $11 278%
Dscc $11 278%
Eastpointe Lme $11 278%
Family Health Network $11 278%
Freedom First Healthcare $11 278%
Ghc Scw Wi Badgercare $11 278%
Harbor Health $11 278%
Health Safety Net $11 278%
Healthy Blue Ne $11 278%
Hennepin Health $11 278%
Humana $11 - $33 278%
Id County Ada $11 278%
Id County Canyon $11 278%
Id County Cat Fund $11 278%
Id County Payette $11 278%
Idaho Womens Health Check $11 278%
Indiana Breast Cervical Cancer $11 278%
Inland Empire Health Plan $11 278%
Intercommunity Health Ohp $11 278%
Iowa Total Care $11 278%
Jai Medical System $11 278%
Kern Family Health Plan $11 278%
Keystone First $11 278%
Keystone First Chip $11 278%
La Care Health Plan $11 278%
Lakeland Care Inc $11 278%
Managed Health Services - Indiana $11 278%
Maryland Breast & Cervical Program $11 278%
Maryland Healthy Smiles - Scion Dental $11 278%
Maryland Physicians Care $11 278%
Massachusetts Behavioral Health Partnership $11 278%
Mdwise $11 278%
Medi-Cal $11 278%
Medi-Cal Healthnet $11 278%
Medstar Dc Healthy Family $11 278%
Medstar Md Health Choice $11 278%
Mo Home State Health Plan $11 278%
Molina Centennial Care $11 278%
Nascentia Health Options $11 278%
Nebraska Total Care $11 278%
New York Cancer Services Program $11 278%
Nextlevel Health $11 278%
Oregon Screenwise $11 278%
Pace Of Southwest Michigan $11 278%
Paramount Advantage $11 278%
Parkland Community Health Plan $11 278%
Partners Behavioral Lme $11 278%
Peach State Healthplan $11 278%
Presbyterian Centennial Care $11 278%
Prestige Health Choice $11 278%
Priority Partners $11 278%
Rx 340B Pass Along $11 278%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $11 278%
Rx Medi-Cal $11 278%
Rx Meridian Rx $11 278%
Sandhills Center Lme $11 278%
Screening For Life $11 278%
Sunshine State Health Plan $11 278%
Superior Health $11 278%
Tenncare $11 278%
Texas Children'S Health Plan $11 278%
Trillium Community Ohp $11 278%
Tufts Health Public Plans $11 278%
Vaya Health Lme $11 278%
Wellsense Health Plan $11 278%
Wi Womens Wellness $11 278%
Selecthealth $13 - $34 329%
Mountain Health Co-Op $23 582%
Pacificsource Health Plans $23 - $36 582%
Allegiance $29 734%
Columbia Health Network $30 759%
Correctional Health Partners $30 759%
Allied National Global Care $34 861%
Asrm - Reliance Standard Life Insurance $34 861%
Christian Care Ministry $34 861%
Dean Health $34 861%
Fallon Health $34 861%
Family Life Insurance Company $34 861%
First Choice Health $34 861%
Ghc Scw $34 861%
International Benefit Administrators $34 861%
Lifetime Benefit Solutions $34 861%
Manhattan Life $34 861%
Pai $34 861%
Pan-American Life $34 861%
Paramount Hmo $34 861%
Phcs $34 861%
Trinity Health Share $34 861%
Lifewise $35 886%
Allied Benefit Systems $36 911%
Ameriben $36 911%
Asr Health Benefits $36 911%
Christian Brother Services $36 911%
First Health $36 911%
Geha $36 911%
Healthez $36 911%
Luminare Health (Detroit) $36 911%
Medi Share $36 911%
Priority Health $36 911%
Providence $36 911%
Rural Carrier Health Benefit Plan $36 911%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 351 Sw 9Th Street, Ontario, OR 97914
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals