Blood test, clotting time (PTT)
Facility: Johnson Memorial Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $13
- Cash Discount Price: $28
- vs. Medicare Baseline: 2.16x 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 $6.01 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 216% of the Medicare baseline (a markup of 116%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $6 - $13 | 100% |
| Medicare (plans) | $6 | 100% |
| Cca Senior Care Options | $6 | 100% |
| Harvard Pilgrim Healthcare | $6 | 100% |
| Geha | $6 | 100% |
| UnitedHealthcare | $6 - $50 | 100% |
| Cigna | $6 - $39 | 100% |
| Aetna | $6 - $12 | 100% |
| Fallon Health | $8 | 133% |
| Centivo | $8 | 133% |
| Connecticare | $10 - $11 | 166% |
| Nippon Life Ins | $12 | 200% |
| Hap | $12 | 200% |
| Gravie Admin Services | $12 | 200% |
| 1199 National Benefit Fund | $12 | 200% |
| Allied Benefit Systems | $12 | 200% |
| Meritain | $12 | 200% |
| Luminare Health | $12 | 200% |
| Webtpa | $12 | 200% |
| Wc Domestic | $13 | 216% |
| Blue Shield - PA (Highmark) | $13 | 216% |
| Blue Shield - Ny Highmark Western | $13 | 216% |
| Pre-Employment | $13 | 216% |
| Blue Benefit Administrators of Massachusetts | $13 | 216% |
| Diversified Administrators | $13 | 216% |
| Wellpoint | $13 | 216% |
| Blue Shield - Wa (Regence) | $13 | 216% |
| Bcn Domestic | $13 | 216% |
| Kaiser Domestic | $13 | 216% |
| Claimdoc | $13 | 216% |
| Blue Shield - Ca | $13 | 216% |
| Innovative Health Plan II | $13 | 216% |
| Blue Shield - Ny Highmark Northeastern | $13 | 216% |
| Blue Care Network | $13 | 216% |
| Unicare | $13 | 216% |
| Blue Distinction Transplant | $13 | 216% |
| Health Choices | $13 | 216% |
| Blue Shield - Id (Regence) | $13 | 216% |
| Connecticut Dept of Correction | $17 | 283% |
| Health New England | $32 | 532% |
| Allegiance | $34 | 566% |
| Health Partners | $34 | 566% |
| Magnacare | $34 | 566% |
| Prime Health Services | $40 | 666% |
| International Benefit Administrators | $42 | 699% |
| Pai | $42 | 699% |
| Asrm - Reliance Standard Life Insurance | $42 | 699% |
| Manhattan Life | $42 | 699% |
| Multiplan | $42 | 699% |
| Family Life Insurance Company | $42 | 699% |
| Trinity Health Share | $42 | 699% |
| Health Smart | $42 | 699% |
| Mvp | $42 | 699% |
| Allied National Global Care | $42 | 699% |
| Dean Health | $42 | 699% |
| Paramount HMO | $42 | 699% |
| Medi Share | $42 | 699% |
| Lifetime Benefit Solutions | $42 | 699% |
| Ghc Scw | $42 | 699% |
| PHCS | $42 | 699% |
| Pan-American Life | $42 | 699% |
| Christian Care Ministry | $42 | 699% |
| United Behavioral Health Eap | $50 | 832% |