CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Mercy Hospital of Buffalo

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $6
  • Cash Discount Price: $11
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Mercy Hospital of Buffalo is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.00x the Medicare baseline. Located in 565 Abbott Road, Buffalo, NY.
Cash / Self-Pay
$11

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

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: $11 (183%)
Insurance Median: $6 (100%)
Cash: $11 (183% of Medicare)
Ins. Median: $6 (100% 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.

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
Independent Health [100165] $5 - $6 83%
Independent Health Essential [100166] $5 83%
Medicaid / KanCare $5 - $6 83%
Iha First Choice [800001] $5 83%
Wellcare Fidelis Dual [450451] $6 100%
Federal Workers Compensation [500100] $6 100%
Hospice [550001] $6 100%
Covid19 Hrsa [45013] $6 100%
Fallon Health [450115] $6 100%
VA Veterans Affairs [700001] $6 100%
Crime Victims [100176] $6 100%
Fidelis Dual Advantage [450120] $6 100%
Univera Healthcare [100169] $6 - $9 100%
Catholic Health Life Pace [400005] $6 100%
Medicare (plans) $6 100%
Seneca Nation [450119] $6 100%
Champ VA [700002] $6 100%
Blue Cross Blue Shield $6 - $14 100%
Humana $6 100%
Tuscarora Nation [550120] $6 100%
Aetna $6 100%
UnitedHealthcare $6 - $7 100%
Univera Healthcare Essential [100170] $6 - $7 100%
Tricare $6 100%
Beacon Essential [350122] $6 100%
Wellcare [450129] $6 100%
Excellus Rochester McD [350117] $6 100%
Cigna $6 100%
Fidelis Exchange [100164] $9 150%
No Fault [114001] $11 183%
Amerigroup [350102] $12 200%
Fidelis Essential [100163] $14 233%
Molina Essential [100167] $14 233%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 565 Abbott Road, Buffalo, NY 14220
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals