CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Adventist Health Reedley

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $7
Cash Discount Price: $4
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Adventist Health Reedley is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.16x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, 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: $4 (67%)

Insurance Median: $7 (116%)

Cash: $4 (67% 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
Healthnet Medi-Cal	$1 - $27	17%
Bc Mcal	$2	33%
Blue Shield Epn - All Other Plans	$2 - $80	33%
Healthnet- All Other Plans	$2 - $78	33%
UnitedHealthcare	$2 - $76	33%
Western Growers/Pinnacle- All Plans	$2 - $83	33%
Blue Shield Non Epn	$3 - $92	50%
Cigna	$3 - $117	50%
Kaiser - All Other Plans	$3 - $90	50%
Physicians Med Group Op/Profee Only- All Plans	$4 - $144	67%
Cal Viva Hlth Mcal - All Plans	$5 - $7	83%
Community Care Ipa Mcal-All Plans	$5 - $9	83%
Dignity Mcal Op/Profee Only-All Other Plans	$5 - $8	83%
Kern Health Systems Mcal-All Plans	$5 - $7	83%
Medi-Cal	$5 - $7	83%
Blue Shield Mcare	$6	100%
Dignity Mcr Adv Op/Profee Only	$6	100%
Fhcn Pace Mcr Adv-All Plans	$6	100%
Healthnet- Mcr Adv	$6	100%
Kaiser Mcr Adv	$6	100%
Phs Prime Health Srvcs	$6	100%
Tricare	$6	100%
Bright Health Mcr Adv - All Plans	$9	150%
Aetna	$10 - $35	166%
Ah Employee Health Plan - All Plans	$11	183%
Blue Cross Blue Shield	$27 - $77	449%

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 $4.
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 Adventist Health Reedley 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.