Blood test, clotting time (PTT)
Facility: Rehabilitation Hospital of Wisconsin
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $60
- Cash Discount Price: $77
- vs. Medicare Baseline: 9.98x 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 998% of the Medicare baseline (a markup of 898%). 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 |
|---|---|---|
| Medica (Under Dean) | $29 - $77 | 483% |
| Dean PPO Hmo/Pos | $29 - $77 | 483% |
| Alliance PPO | $29 - $77 | 483% |
| UnitedHealthcare | $30 - $112 | 499% |
| Wps "Insurance" PPO | $31 - $82 | 516% |
| Trilogy PPO | $31 - $112 | 516% |
| PHCS Savility | $32 - $84 | 532% |
| Hps Solutions PPO | $32 - $85 | 532% |
| Aetna | $33 - $112 | 549% |
| Health Eos Poc | $34 - $90 | 566% |
| Coventry/First Health PPO | $35 - $92 | 582% |
| Hps (Other) | $35 - $92 | 582% |
| Health Eos Multiplan | $36 - $95 | 599% |
| PHCS / Multiplan | $39 - $103 | 649% |
| Unity Health Plan and Unity Quartz(Hmo/Pos) | $43 - $112 | 715% |
| Wellcare McR | $43 - $112 | 715% |
| Cigna | $43 - $112 | 715% |
| Medicare (plans) | $43 - $112 | 715% |
| Security Health Plan - Advocare | $43 - $112 | 715% |
| Medicaid / KanCare | $43 - $112 | 715% |
| Blue Cross Blue Shield | $43 - $112 | 715% |
| Centivo Narrow/Value | $43 - $112 | 715% |
| Network Health - Commercial | $43 - $112 | 715% |
| Managed Health Services (Mhs) | $43 - $112 | 715% |
| Network Health - Aca | $43 - $112 | 715% |
| Humana | $43 - $112 | 715% |
| Children's Communty Health Plan(Cchp) | $43 - $112 | 715% |
| Community Care, Inc | $43 - $112 | 715% |
| Icare McD | $43 - $112 | 715% |
| Together With Cchp | $43 - $112 | 715% |
| Centivo Broad | $43 - $112 | 715% |
| Centivo Intermediate/Median | $43 - $112 | 715% |
| Molina (Fka Care Wisconsin) | $43 - $112 | 715% |
| Quartz (Self Funded) / Unity Health Plan (Hmo/Pos) | $43 - $112 | 715% |
| All Savers | $43 - $112 | 715% |
| VA - Primary Only - Authorization Required | $43 - $112 | 715% |