CMS Price Transparency Data

Blood test, urea nitrogen (BUN, kidney)

Facility: Stoughton Hospital

Billing Code: 84520 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84520
Insurance Median: $27
Cash Discount Price: $50
vs. Medicare Baseline: 6.84x Medicare

The contracted insurance negotiated median rate for a Blood test, urea nitrogen (BUN, kidney) at Stoughton Hospital is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $3.95, this hospital’s rate is 6.84x the Medicare baseline. Located in 900 Ridge St, Stoughton, WI.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$27

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: $50 (1266%)

Insurance Median: $27 (684%)

Cash: $50 (1266% of Medicare)

Ins. Median: $27 (684% 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 684% of the Medicare baseline (a markup of 584%). 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
Alliance - All Plans	$4	101%
Medicaid / KanCare	$5	127%
Tricare	$21	532%
Dean Health Insurance Comm - All Other Plans	$22	557%
Dean Health Insurance Epo	$22	557%
Healthnet Mcr Adv - All Plans	$24	608%
Dean Health Insurance Med Adv	$25	633%
Humana	$25 - $81	633%
Quartz Mcr Adv	$25	633%
Security Health/First Health - All Plans	$25	633%
Aetna	$27 - $76	684%
UnitedHealthcare	$40 - $72	1013%
Geha - All Plans	$68	1722%
Cigna	$72	1823%
Wisconsin Ppo Ppa Direct - All Plans	$72	1823%
Quartz Health Solutions - All Other Lans	$76	1924%
Blue Cross Blue Shield	$78	1975%
Wps - All Plans	$81	2051%

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 $50.
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 Stoughton Hospital 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.