CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Saint Joseph Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $54
Cash Discount Price: Unavailable
vs. Medicare Baseline: 8.99x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Saint Joseph Hospital is $54. 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 8.99x the Medicare baseline. Located in 1375 E 19Th Ave, Denver, CO.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$54

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: $54 (899%)

Ins. Median: $54 (899% 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 899% of the Medicare baseline (a markup of 799%). 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
Cigna	$4 - $135	67%
Geha	$6 - $78	100%
Select Health	$6	100%
UnitedHealthcare	$6 - $78	100%
Blue Cross Blue Shield	$11 - $110	183%
Denv Hlth Med Plan	$16	266%
Kaiser Perm Hmo	$20 - $57	333%
Kaiser Self Funded	$24 - $57	399%
Kaiser Perm Ppo/Pos	$25 - $59	416%
Allegiance	$27 - $34	449%
Kaiser Mrp	$27 - $34	449%
Kaiser Snp	$27 - $34	449%
Aetna	$40 - $121	666%
Preferred One	$42 - $54	699%
Humana	$45 - $57	749%
Cofinity	$77 - $97	1281%
First Health Network	$77 - $97	1281%
Private Hlthcare Sys	$80 - $101	1331%
Multiplan Inc	$89 - $114	1481%
Midlands Choice	$103 - $131	1714%

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 $X.
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 Saint Joseph Hospital 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.