CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: UPMC Hamot

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84520
  • Insurance Median: $19
  • Cash Discount Price: $56
  • vs. Medicare Baseline: 4.81x Medicare
The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at UPMC Hamot is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 4.81x the Medicare baseline. Located in 201 State Street, Erie, PA.
Cash / Self-Pay
$56

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $56 (1418%)
Insurance Median: $19 (481%)
Cash: $56 (1418% of Medicare)
Ins. Median: $19 (481% 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 481% of the Medicare baseline (a markup of 381%). 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.

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 - $65 101%
Amerihealth Caritas $4 - $8 101%
Blue Cross Blue Shield $4 - $37 101%
Cigna $4 - $37 101%
Fidelis $4 101%
Highmark Wholecare (Prev Gateway) $4 - $46 101%
Independent Health $4 101%
Pa Health & Wellness $4 - $9 101%
UnitedHealthcare $4 - $6 101%
Upmc Health Plan $4 - $15 101%
Upmc Work Partners $4 101%
Wellcare $4 101%
Health Partners Plans (Jefferson Health Plan) $5 127%
Geisinger $8 203%
Univera $14 - $41 354%
Intergroup $60 - $74 1519%
Multiplan $65 - $74 1646%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 State Street, Erie, PA 16550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals