CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Adventist Health Vallejo

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $10
Cash Discount Price: $5
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Adventist Health Vallejo is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.66x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.

Cash / Self-Pay

Average discount available for prompt cash payment at this facility.

Insurance Median

$10

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: $5 (83%)

Insurance Median: $10 (166%)

Cash: $5 (83% of Medicare)

Ins. Median: $10 (166% 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 Shield Behav Hlth	$2 - $125	33%
Blue Shield Non-Epn-All Other Plans	$2 - $129	33%
Healthnet-All Plans	$2 - $17	33%
UnitedHealthcare	$2 - $177	33%
Blue Shield Epn	$3 - $130	50%
Interplan-All Plans	$3 - $180	50%
Phcs-All Plans	$3 - $152	50%
Western Growers-All Plans	$3 - $147	50%
Beech Street-All Plans	$4 - $208	67%
Choicecare-All Plans	$4 - $194	67%
Cigna	$4 - $222	67%
Kaiser-All Plans	$4 - $233	67%
Galaxy Network-All Plans	$5 - $249	83%
Health Management Network-All Plans	$5 - $235	83%
Medi-Cal	$5 - $7	83%
Three Rivers-All Plans	$5 - $249	83%
Va Medi-Cal	$5 - $7	83%
Blue Shield Mcr Adv	$6	100%
Medicare (plans)	$6	100%
Napa County Mcal Child	$6	100%
Tricare	$6	100%
Va Mcr-All Other Plans	$6	100%
Ah Employee Health Plan-All Plans	$11	183%
Aetna	$35	582%
Blue Cross Blue Shield	$58 - $69	965%

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 $5.
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 Vallejo 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.