CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Modoc Medical Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $86
Cash Discount Price: $99
vs. Medicare Baseline: 14.31x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Modoc Medical Center is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 14.31x the Medicare baseline. Located in 1111 N Nagle Street, Alturas, CA.

Cash / Self-Pay

$99

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $99 (1647%)

Insurance Median: $86 (1431%)

Cash: $99 (1647% of Medicare)

Ins. Median: $86 (1431% 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 1431% of the Medicare baseline (a markup of 1331%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Integrated Hp Wc	$6	100%
Multiplan Wc	$6	100%
Ntwrks By Design Wc - All Plans	$6	100%
Adv Med Mgmt - All Plans	$7	116%
Medi-Cal	$7	116%
Medi-Cal 7/1/24	$7	116%
Partnership Hp - All Plans	$7	116%
Blue Shield Mcr Adv	$54	899%
Blue Shield Va	$54	899%
UnitedHealthcare	$54 - $94	899%
Tricare	$56	932%
Healthnet Mcr Adv	$57	948%
Blue Cross Blue Shield	$81 - $90	1348%
Blue Shield Exch	$81	1348%
Blue Shield Comm - All Other Plans	$90	1498%
Carelon - All Plans	$90	1498%
Corvel - All Plans	$93	1547%
Aetna	$94	1564%
Coventry/First Health - All Plans	$94	1564%
Galaxy Health - All Plans	$94	1564%
Healthnet Comm - All Other Plans	$94	1564%
Hmn - All Plans	$94	1564%
Integrated Hp - All Other Plans	$94	1564%
Interplan - All Plans	$94	1564%
Multiplan - All Other Plans	$94	1564%
Superior Ca Ppo - All Plans	$94	1564%

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 $99.
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 Modoc Medical Center 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.