CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: Holy Family Memorial

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84520
  • Insurance Median: $14
  • Cash Discount Price: $14
  • vs. Medicare Baseline: 3.54x Medicare
The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Holy Family Memorial is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 3.54x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.
Cash / Self-Pay
$14

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

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: $14 (354%)
Insurance Median: $14 (354%)
Cash: $14 (354% of Medicare)
Ins. Median: $14 (354% 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 354% of the Medicare baseline (a markup of 254%). 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
Allwell $4 101%
Blue Cross Blue Shield $4 - $5 101%
Community Care Incorporated $4 101%
Health Partners $4 - $17 101%
Humana $4 101%
Icare $4 101%
Molina $4 101%
Network Health Plan $4 - $14 101%
Security Health Plan $4 - $21 101%
UnitedHealthcare $4 - $5 101%
Medical College Of Wisconsin $9 228%
Centivo $10 - $12 253%
Health Payment Systems $10 253%
Chorus Community Health Plan $11 278%
Dean Health Plan $13 329%
Sheboygan Employers Health Network $16 405%
Trilogy $17 430%
Cigna $19 481%
Wps Health Plan $19 481%
Aspirus $21 532%
Healtheos $21 532%
Multiplan/Private Healthcare Systems $21 532%
Preferred One $21 532%
Healthsmart $22 557%
First Health Network $23 582%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 Western Ave, Manitowoc, WI 54221
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals