Blood test, urea nitrogen (BUN, kidney)
Facility: Regional Medical Center
Billing Code: 84520 (CPT)
- CPT Billing Code: 84520
- Insurance Median: $870
- Cash Discount Price: $27
- vs. Medicare Baseline: 220.25x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 22025% of the Medicare baseline (a markup of 21925%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 22025% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Regional Medical Center in Manchester, Iowa, the gross chargemaster rate of $34 is significantly higher than the state average of $27. While the facility is a government-owned Critical Access Hospital with a strong 4-star rating, patients should be aware that commercial insurance plans, specifically Medical Associates Health Plan - Tri, negotiate a fixed rate of $870 for this service. This negotiated rate is notably higher than the facility's cash price, which is set at $27, meaning paying out-of-pocket directly could result in substantial savings compared to using insurance coverage.
The Medicare benchmark for this code is $3.95, which serves as a baseline for understanding the cost structure, though the commercial negotiated rate of $870 reflects the administrative and contractual complexities of insurance billing. Given that the cash price of $27 is far below the negotiated amount, patients with high-deductible plans or those without insurance may find it financially advantageous to pay the self-pay rate directly. To ensure you receive the best possible price, it is recommended to explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling the test, as these upfront payment incentives can further reduce the final amount owed.