CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: St Francis Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $61
Cash Discount Price: $73
vs. Medicare Baseline: 10.15x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at St Francis Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 10.15x the Medicare baseline. Located in 1215 Franciscan Dr, Litchfield, IL.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$6.01

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.01 (100%)

Cash / Self-Pay: $73 (1215%)

Insurance Median: $61 (1015%)

Cash: $73 (1215% of Medicare)

Ins. Median: $61 (1015% of 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 1015% of the Medicare baseline (a markup of 915%). 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
Wexford	$4	67%
Meridian Health Plan	$5	83%
Molina Healthcare	$5 - $143	83%
Clear Spring Health of Illinois	$13 - $143	216%
Humana	$13 - $143	216%
Blue Cross Blue Shield	$13 - $143	216%
Aetna	$13 - $143	216%
UnitedHealthcare	$13 - $143	216%
Amish Community	$17 - $40	283%
Celtic Insurance Company	$31 - $315	516%
Claim Doc	$32 - $358	532%
Hopetrust	$35 - $358	582%
Wellfirst	$39 - $92	649%
First Health	$45 - $106	749%
Caterpillar, Inc.	$49 - $115	815%
Cigna	$49 - $114	815%
Current Health Solutions	$51 - $120	849%
Healthlink	$52 - $122	865%
Consociate Group	$52 - $122	865%
Multiplan/Phcs	$52 - $122	865%
Healthcare Finest Network (Hfn)	$55 - $129	915%
Provider Network of America	$55 - $129	915%
Health Alliance Medical Plans	$61 - $143	1015%
Illinois Breast and Cervical Cancer Program	$61 - $143	1015%
Live360	$61 - $143	1015%
Naphcare	$61 - $143	1015%
Healthscope	$61 - $143	1015%
Interplan	$61 - $143	1015%

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 $73.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85730.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Francis Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85730.
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.