CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Valley Children's Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $277
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 46.09x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Valley Children's Hospital is $277. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 46.09x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$277

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%)
Insurance Median: $277 (4609%)
Ins. Median: $277 (4609% 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 4609% of the Medicare baseline (a markup of 4509%). 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
Allcare Ipa $8 133%
Central California Alliance For Health $12 200%
Dignity Ipa_Formerly Img $12 200%
Kaiser $12 - $327 200%
La Salle Ipa $12 200%
Sante Ipa $12 200%
Central Valley Medical Providers Ipa $13 - $252 216%
Community Care Ipa $13 216%
Sequoia Health Ipa $13 216%
United Physicians Network Ipa $13 216%
Univseral Healthcare Ipa $13 216%
Adventist $15 250%
Blue Cross Blue Shield $15 - $60 250%
Cencal Health $17 283%
Kern Family Health Care $17 283%
Health Net $177 - $329 2945%
Dignity Health Central Coast $249 4143%
Community Health $277 4609%
Stanislaus Partners In Health $277 4609%
Physicians Choice Medical Group $282 4692%
Health Plan Of San Joaquin $302 5025%
Fowler Packing $312 5191%
Dignity (Formerly Managed Care Systems) $317 5275%
Kern Legacy $327 5441%
Blue Shield $336 - $382 5591%
Aetna $337 5607%
First Health Formerly Coventry $372 6190%
Bakersfield Family Medical Group $377 6273%
Network By Design $390 6489%
Community Care Health Plan $402 6689%
Health Smart $402 6689%
Key Medical Ipa $402 6689%
UnitedHealthcare $409 6805%
Sutter Health $428 7121%
Multiplan $481 8003%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens