CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: City of Hope National Medical Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $7
Cash Discount Price: $8
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at City of Hope National Medical Center is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.16x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $8 (133%)

Insurance Median: $7 (116%)

Cash: $8 (133% of Medicare)

Ins. Median: $7 (116% 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.

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
Blue Cross Blue Shield	$1 - $60	17%
Blue Shield	$1 - $93	17%
Heritage Provider Network	$1 - $50	17%
UnitedHealthcare	$1 - $40	17%
Aetna	$2 - $72	33%
Blue Shield Covca	$2 - $44	33%
Blue Shield Promise	$2 - $50	33%
Cencal	$2 - $57	33%
Gold Coast	$2 - $72	33%
Health Net	$2 - $70	33%
Inland Empire	$2 - $57	33%
Kaiser	$2 - $65	33%
La Care Health	$2 - $57	33%
Molina	$2 - $93	33%
Prime Healthcare Keenan	$2 - $69	33%
Cigna	$3 - $77	50%
Healthcare Partners	$3 - $83	50%
Primecare Medical Network	$3 - $93	50%
St. Joseph Heritage	$3 - $86	50%
First Health	$4 - $111	67%
Phcs Multiplan	$4 - $129	67%
Cal Optima	$5 - $7	83%
Facey	$5 - $8	83%

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 $8.
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 City of Hope National Medical Center 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.