Blood test, clotting time (PTT)
Facility: John Muir Medical Center - Walnut Creek Campus
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $24
- Cash Discount Price: $18
- vs. Medicare Baseline: 3.99x 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 399% of the Medicare baseline (a markup of 299%). 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 |
|---|---|---|
| Carecentrix [1011001] | $1 - $170 | 17% |
| Generic Commercial/Indemnity [1017001] | $1 - $170 | 17% |
| Aps Healthcare [1003103] | $2 - $191 | 33% |
| Blue Cross Blue Shield | $2 - $276 | 33% |
| Blue Shield Hmo [1006103] | $2 - $270 | 33% |
| Blue Shield Ppo [1006104] | $2 - $313 | 33% |
| Blue Shield-Network [1006026] | $2 - $270 | 33% |
| Carelon Behavioral Health [1050104] | $2 - $234 | 33% |
| Cigna | $2 - $304 | 33% |
| Contra Costa Health Plan Hmo [1013103] | $2 - $255 | 33% |
| Fortified Provider Network [1063104] | $2 - $234 | 33% |
| Health Net Hmo [1028103] | $2 - $243 | 33% |
| Health Net-Network [1028026] | $2 - $243 | 33% |
| Medigap [1036001] | $2 - $234 | 33% |
| Three Rivers Provider Network [1073104] | $2 - $234 | 33% |
| United Behavioral Health [1048103] | $2 - $214 | 33% |
| UnitedHealthcare | $2 - $249 | 33% |
| Aetna | $3 - $307 | 50% |
| Federal Correction Institute [1062104] | $3 - $340 | 50% |
| First Health [1016104] | $3 - $361 | 50% |
| Galaxy Health Network [1064104] | $3 - $383 | 50% |
| Health Management Network [1066104] | $3 - $361 | 50% |
| Health Net Ppo [1028104] | $3 - $309 | 50% |
| Healthcomp [1089104] | $3 - $361 | 50% |
| Healthsmart - Pka Interplan [1031104] | $3 - $340 | 50% |
| Humana | $3 - $353 | 50% |
| Integrated Health Plan [1075104] | $3 - $383 | 50% |
| Kaiser Hmo [1033103] | $3 - $344 | 50% |
| Medicare (plans) | $3 - $340 | 50% |
| National Provider Network/Plancare America [1069104] | $3 - $340 | 50% |
| Networks By Design [1084104] | $3 - $340 | 50% |
| Pponext [1072104] | $3 - $340 | 50% |
| Sutter Preferred Health Plan [1044104] | $3 - $340 | 50% |
| Western Health Advantage Hmo [1053103] | $3 - $340 | 50% |
| Contra Costa County Jail [1012104] | $5 | 83% |
| Alignment Health [1177113] | $6 | 100% |
| Blue Shield-Network Mcare [1006127] | $6 | 100% |
| Care 1St Health Plan [1094113] | $6 | 100% |
| Caremore [1171113] | $6 | 100% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] | $6 | 100% |
| Easy Choice Health Plan [1083113] | $6 | 100% |
| Essence Healthcare [1049028] | $6 | 100% |
| Essence Healthcare [1049128] | $6 | 100% |
| Golden State-Network Mcare [1023127] | $6 | 100% |
| Health Net-Network Mcare [1028127] | $6 | 100% |
| Hospice Of East Bay [1085104] | $6 | 100% |
| Scan-Network Mcare [1043127] | $6 | 100% |
| Veterans Administration [1051113] | $6 | 100% |
| Jmpn Canopy Hn [1640000011] | $7 | 116% |
| Generic Hmo [1018103] | $8 | 133% |
| Generic Ppo [1021104] | $8 | 133% |
| Canopy Hn Hmo [1166103] | $11 | 183% |
| Brms [1091104] | $81 | 1348% |
| Delta Health Systems [1032104] | $81 | 1348% |
| Empire Plan [1092104] | $81 | 1348% |
| Donor Network West [1008103] | $4,000 | 66556% |