CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: UPMC Somerset

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84520
Insurance Median: $13
Cash Discount Price: $21
vs. Medicare Baseline: 3.29x Medicare

The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at UPMC Somerset is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 3.29x the Medicare baseline. Located in 225 South Center Avenue, Somerset, PA.

Cash / Self-Pay

$21

Average discount available for prompt cash payment at this facility.

Insurance Median

$13

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: $21 (532%)

Insurance Median: $13 (329%)

Cash: $21 (532% of Medicare)

Ins. Median: $13 (329% 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 329% of the Medicare baseline (a markup of 229%). 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
Amerihealth Caritas	$4 - $6	101%
Blue Cross Blue Shield	$4 - $8	101%
Highmark Wholecare (Prev Gateway)	$4 - $7	101%
UnitedHealthcare	$4 - $13	101%
Upmc Health Plan	$4 - $30	101%
Upmc Work Partners	$4	101%
Cbhnp	$5	127%
Ccbhn	$5	127%
Geisinger	$8 - $14	203%
Aetna	$14	354%
Multiplan	$18 - $23	456%
Galaxy Health Plan	$23	582%
Humana	$26 - $27	658%

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 $21.
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 UPMC Somerset 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.