CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Children's Hospital Colorado

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $100
  • Cash Discount Price: $118
  • vs. Medicare Baseline: 16.64x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Children's Hospital Colorado is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 16.64x the Medicare baseline. Located in 13123 E 16Th Ave, Aurora, CO.
Cash / Self-Pay
$118

Average discount available for prompt cash payment at this facility.

Insurance Median
$100

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: $118 (1963%)
Insurance Median: $100 (1664%)
Cash: $118 (1963% of Medicare)
Ins. Median: $100 (1664% 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 1664% of the Medicare baseline (a markup of 1564%). 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
Ccha Behavioral Health $4 - $29 67%
Integrated Health Plan $7 - $44 116%
Kaiser $15 - $212 250%
Rocky Mountain Health Plan Behavioral Health $18 - $116 300%
Carelon Behavioral Health $20 - $203 333%
Denver Health Medical Plan $20 - $218 333%
UnitedHealthcare $20 - $145 333%
Presbyterian Health Plan $21 - $165 349%
Colorado Access $22 - $142 366%
Colorado Access Behavioral Health $22 - $142 366%
Blue Cross Blue Shield $23 - $218 383%
Molina Healthcare Of Nebraska $24 - $160 399%
Molina Healthcare Of New Mexico $24 - $160 399%
Peak Health Alliance/Ebms $24 - $174 399%
Rocky Mountain Health Plan $24 - $188 399%
Healthy Blue Of Nebraska $26 - $168 433%
Humana $27 - $203 449%
Evernorth Behavioral Health $29 - $188 483%
Interlink National $29 - $218 483%
Centivo $30 - $200 499%
Select Health $31 - $203 516%
Uchealth Plan Administrators $31 - $203 516%
Aetna $32 - $232 532%
Cigna $32 - $209 532%
Department Of Corrections $34 - $226 566%
Comppsych Behavioral Health $37 - $246 616%
First Choice Health $37 - $246 616%
Midlands Choice $37 - $246 616%
National Preferred Provider Network $37 - $246 616%
Multiplan $38 - $249 632%
Cofinity $40 - $261 666%
First Choice Of The Midwest $40 - $261 666%
First Health Network $40 - $267 666%
Usa Managed Care Organization $40 - $261 666%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13123 E 16Th Ave, Aurora, CO 80045
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens