CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Mayers Memorial Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $84
  • Cash Discount Price: $98
  • vs. Medicare Baseline: 13.98x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Mayers Memorial Hospital is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 13.98x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.
Cash / Self-Pay
$98

Average discount available for prompt cash payment at this facility.

Insurance Median
$84

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: $98 (1631%)
Insurance Median: $84 (1398%)
Cash: $98 (1631% of Medicare)
Ins. Median: $84 (1398% 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 1398% of the Medicare baseline (a markup of 1298%). 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
Medi-Cal $7 116%
Partnership Hp-All Plans $7 116%
Blue Shield Ca Va $61 1015%
Blue Shield Mcr Adv $61 1015%
Arcadian Health Services-All Plans $65 1082%
Blue Cross Blue Shield $65 - $84 1082%
Health Net Mcr Adv $65 1082%
Tricare $65 1082%
Health Net Prison $70 1165%
Imperial Health Plan-All Plans $73 1215%
Blue Shield Ca Exchange $84 1398%
Blue Shield-All Other Plans $93 1547%
Cigna $93 1547%
Corvel Ppo-All Plans $93 1547%
Coventry/First Health-All Plans $93 1547%
Hmn-All Plans $93 1547%
Integrated Hp-All Plans $93 1547%
Interplan-All Plans $93 1547%
Multiplan Phcs-All Plans $93 1547%
Pfmc-All Plans $93 1547%
Superior Ca-All Plans $93 1547%
Health Net-All Other Plans $98 1631%
Pacificare-All Plans $98 1631%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43563 Hwy 299 East, Fall River Mills, CA 96028
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals