CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: John Muir Behavioral Health Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $19
Cash Discount Price: $17
vs. Medicare Baseline: 3.16x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at John Muir Behavioral Health Center is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 3.16x the Medicare baseline. Located in 2740 Grant Street, Concord, CA.

Cash / Self-Pay

$17

Average discount available for prompt cash payment at this facility.

Insurance Median

$19

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: $17 (283%)

Insurance Median: $19 (316%)

Cash: $17 (283% of Medicare)

Ins. Median: $19 (316% 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 316% of the Medicare baseline (a markup of 216%). 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
Aetna	$2 - $292	33%
Aps Healthcare [1003103]	$2 - $292	33%
Blue Cross Blue Shield	$2 - $292	33%
Blue Shield Hmo [1006103]	$2 - $234	33%
Blue Shield Ppo [1006104]	$2 - $234	33%
Blue Shield-Network [1006026]	$2 - $234	33%
Brms [1091104]	$2 - $292	33%
Carelon Behavioral Health [1050104]	$2 - $268	33%
Contra Costa County Jail [1012104]	$2 - $214	33%
Delta Health Systems [1032104]	$2 - $292	33%
Empire Plan [1092104]	$2 - $292	33%
Federal Correction Institute [1062104]	$2 - $214	33%
Fortified Provider Network [1063104]	$2 - $214	33%
Galaxy Health Network [1064104]	$2 - $214	33%
Health Management Network [1066104]	$2 - $214	33%
Health Net Hmo [1028103]	$2 - $268	33%
Health Net Ppo [1028104]	$2 - $268	33%
Health Net-Network [1028026]	$2 - $268	33%
Healthcomp [1089104]	$2 - $292	33%
Healthsmart - Pka Interplan [1031104]	$2 - $214	33%
Hospice Of East Bay [1085104]	$2 - $214	33%
Humana	$2 - $214	33%
Integrated Health Plan [1075104]	$2 - $214	33%
Kaiser Hmo [1033103]	$2 - $292	33%
Medigap [1036001]	$2 - $214	33%
National Provider Network/Plancare America [1069104]	$2 - $214	33%
Networks By Design [1084104]	$2 - $214	33%
Pponext [1072104]	$2 - $214	33%
Sutter Preferred Health Plan [1044104]	$2 - $214	33%
Three Rivers Provider Network [1073104]	$2 - $214	33%
Beacon Health Strategies [1005103]	$3 - $390	50%
Carecentrix [1011001]	$3 - $361	50%
Cigna	$3 - $366	50%
Donor Network West [1008103]	$3 - $361	50%
Generic Commercial/Indemnity [1017001]	$3 - $361	50%
Western Health Advantage Hmo [1053103]	$3 - $361	50%
Alignment Health [1177113]	$6	100%
Care 1St Health Plan [1094113]	$6	100%
Caremore [1171113]	$6	100%
Essence Healthcare [1049128]	$6	100%
Medicare (plans)	$6	100%
Generic Hmo [1018103]	$8	133%
Generic Ppo [1021104]	$8	133%

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 $17.
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 John Muir Behavioral Health 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.