CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Adventist Health Tulare

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $9
Cash Discount Price: $7
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Adventist Health Tulare is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.50x the Medicare baseline. Located in 869 North Cherry Street, Tulare, 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: $7 (116%)

Insurance Median: $9 (150%)

Cash: $7 (116% of Medicare)

Ins. Median: $9 (150% 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	$2 - $61	33%
Blue Shield Epn	$2 - $143	33%
Blue Shield-All Other Plans	$2 - $198	33%
Cigna	$2 - $210	33%
Western Growers - All Plans	$2 - $209	33%
Network By Design-All Plans	$3 - $295	50%
Hs Interplan-All Plans	$4 - $304	67%
UnitedHealthcare	$4 - $329	67%
Ccipa Medi-Cal - All Plans	$5 - $9	83%
Dignity Mcal Op Only	$5 - $8	83%
Healthnet Medi-Cal	$5 - $9	83%
Independence Op Only - All Plans	$5 - $8	83%
Medi-Cal	$5 - $7	83%
Multiplan - All Plans	$5 - $386	83%
Blue Shield Mcare	$6	100%
Dignity Mcr Op Only - All Other Plans	$6	100%
Fhcn Pace Mcr Adv - All Plans	$6	100%
Medicare (plans)	$6	100%
Prime Health - All Plans	$6	100%
Tricare	$6	100%
Cal Forensic Med Grp - All Plans	$8	133%
Prison Hlthcre - All Plans	$8	133%
Bright Health - All Plans	$9	150%
Ah Employee Health Plan - All Plans	$11	183%
Incentive Hlth - All Plans	$11	183%
Healthnet Hmo/Ppo - All Other Plans	$16	266%
Aetna	$52	865%

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 $7.
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 Tulare 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.