CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Grossmont Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $36
Cash Discount Price: $53
vs. Medicare Baseline: 5.99x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Grossmont Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 5.99x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$53

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $53 (882%)

Insurance Median: $36 (599%)

Cash: $53 (882% of Medicare)

Ins. Median: $36 (599% 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 599% of the Medicare baseline (a markup of 499%). 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
Medicare (plans)	$1 - $8	17%
Blue Cross Blue Shield	$3 - $72	50%
Aetna	$4 - $626	67%
Health Net	$4 - $116	67%
Blue Shield	$6 - $89	100%
Cigna	$6 - $62	100%
Managed Health Network	$6 - $38	100%
Molina	$6 - $90	100%
Community Health Group	$8 - $38	133%
Indian Health Council	$8 - $79	133%
Interplan	$8 - $86	133%
Epic Americas	$9 - $88	150%
Humana	$9	150%
Medi-Cal	$9	150%
UnitedHealthcare	$9 - $80	150%
Kaiser	$11 - $103	183%
San Diego Pace	$62	1032%
Multiplan	$79	1314%
Allianz Global Assistance	$82 - $87	1364%
California Health And Wellness	$106 - $626	1764%

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 $53.
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 Grossmont 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.