CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Alhambra Hospital Medical Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $23
  • Cash Discount Price: $165
  • vs. Medicare Baseline: 3.83x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Alhambra Hospital Medical Center is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $165. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 3.83x the Medicare baseline. Located in 100 S Raymond Ave, Alhambra, CA.
Cash / Self-Pay
$165

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $165 (2745%)
Insurance Median: $23 (383%)
Cash: $165 (2745% of Medicare)
Ins. Median: $23 (383% 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 383% of the Medicare baseline (a markup of 283%). 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.

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
Stewart Mg Senior Hmo $4 67%
Ahmc-Reciprocity-Medi-Cal/Healthy Families $5 83%
Citrus Valley Health Partners $5 83%
Kaiser Medi-Cal $5 83%
La Care Pasc Seiu Misc $5 83%
Miscellaneous Medi-Cal Hmo $5 83%
Aetna $6 - $10 100%
Alignment Senior Hmo $6 100%
Allied Physicians Of Ca Medi-Cal $6 100%
Altamed Senior Services $6 100%
Apa Aco $6 100%
Blue Cross Blue Shield $6 - $11 100%
Blue Shield 65 Plus $6 100%
Brand New Day Sr $6 100%
Central Health Plan Of Ca Senior Hmo $6 100%
Health Net Medi-Cal $6 100%
Health Net Senior Hmo $6 100%
Humana $6 100%
La Care Exchange $6 100%
La Care Medi-Cal Hmo $6 100%
Medi-Cal $6 100%
Medicare (plans) $6 - $161 100%
Miscellaneous Senior Hmo $6 100%
UnitedHealthcare $6 - $12 100%
Wellcare Senior Hmo $6 100%
Cigna $7 - $121 116%
Health Net Exchange $7 116%
Health Net Salud Con Hmo $7 116%
Miscellaneous Work Comp Hmo $7 116%
Molina Exchange $7 116%
Tricare $7 116%
Ahmc Health $9 150%
Allied Physicians Of Ca Commercial $9 150%
Health Net Ppo/Epo/Pos $13 216%
Ahmc-Reciprocity-Comm/Senior $17 - $80 283%
Allied Physicians Comm/Sr $20 - $94 333%
Allied Physicians Medi-Cal $20 - $94 333%
Wellcare Allied Senior Hmo $20 - $94 333%
Molina Health Plan $22 - $104 366%
Self Pay $23 - $107 383%
Health Net Exchange Enhanced Ppo $24 - $114 399%
Kaiser Commercial $36 - $166 599%
Scan Senior Plan $37 - $174 616%
Multiplan $46 - $214 765%
Miscellaneous Commercial Ppo/Hmo $57 - $268 948%
Blue Shield Value Network Exchange $75 1248%
Blue Shield Hmo/Ppo $83 1381%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 S Raymond Ave, Alhambra, CA 91801
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals