CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: Mountain West Medical Center

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84520
  • Insurance Median: $135
  • Cash Discount Price: $113
  • vs. Medicare Baseline: 34.18x Medicare
The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Mountain West Medical Center is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 34.18x the Medicare baseline. Located in 2055 North Main Street, Tooele, UT.
Cash / Self-Pay
$113

Average discount available for prompt cash payment at this facility.

Insurance Median
$135

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: $113 (2861%)
Insurance Median: $135 (3418%)
Cash: $113 (2861% of Medicare)
Ins. Median: $135 (3418% 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 3418% of the Medicare baseline (a markup of 3318%). 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
Select Health McR Adv $4 101%
Blue Cross Blue Shield $4 101%
Medicare (plans) $5 127%
Pehp-All Plans $7 177%
U of Ut-All Plans $123 3114%
Wise/Motivhealth-All Plans $123 3114%
Cigna $134 3392%
Dmba-All Plans $136 3443%
Select Health-All Other Plans $141 3570%
Aetna $141 3570%
UnitedHealthcare $145 3671%
Multiplan Primary Network-All Other Plans $149 3772%
Emi-All Plans $160 4051%
Humana $160 4051%
Multiplan Complimentary Network $174 4405%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2055 North Main Street, Tooele, UT 84074
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals