CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Hialeah Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $7
  • Cash Discount Price: $464
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Hialeah Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $464. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.16x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$464

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $464 (7720%)
Insurance Median: $7 (116%)
Cash: $464 (7720% of Medicare)
Ins. Median: $7 (116% 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.

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
Humana $2 - $213 33%
Medicaid / KanCare $2 33%
UnitedHealthcare $2 - $6 33%
Cigna $3 - $137 50%
Veterans Administration Mill Bill $4 67%
Avmed Broad Network $5 83%
Medicare (plans) $5 - $13 83%
Aetna $6 - $334 100%
Bristol Hospice- Miami Dade Llc $6 100%
Catholic Hospice $6 100%
Comprehensive Home Health Care Dba Opuscare Of South Florida $6 100%
Devoted Health $6 100%
Employer Direct Healthcare $6 - $8 100%
Hcr Manor Care Services Of Fl $6 100%
Healthsun Health Plans $6 100%
Hospice Other $6 100%
Leon Health Inc $6 100%
Longevity Health Plan $6 100%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $6 100%
Seasons Hospice And Pallative Care Of Southern Florida Inc $6 100%
Tricare $6 100%
Veterans Administration Vaccn $6 100%
Vitas Healthcare Hospice Corporation Of Fl $6 100%
Vitas Hospice Unit Agreement $6 100%
Bright Health Management Commercial $7 116%
Dimension Health Wc $7 116%
Florida Pace Centers $7 116%
Imagine Health $7 116%
Oscar Health Plan Hix $7 116%
Self Pay/Uninsured $7 116%
Workers Compensation $7 116%
Naphcare Inc $8 133%
Ambetter / Centene $11 183%
Avmed Exchange $11 183%
Molina Marketplace Program Exchange $11 183%
Auto Insurance $12 200%
Avmed Select Network $12 200%
Amerihealth Caritas Next Exchange $13 216%
Bc/Bs Myblue Hmo Hix $57 948%
Bc/Bs Of Fl Health Options Hmo $62 1032%
Bc/Bs Of Fl Simplyblue $62 1032%
Bc/Bs Of Fl Network Blue $67 1115%
Bc/Bs Of Fl Ppo $67 1115%
Bc/Bs Of Fl Blue Select Exchange Non Par $71 1181%
Bc/Bs Of Fl Miami Dade Blue Select $71 1181%
Bc/Bs Of Fl Phs $241 4010%
Dimensions International $302 5025%
First Health $316 5258%
Dimension Health Ppo $348 5790%
Commercial Non-Contracted $464 7720%
Self Pay - Mcd Pending 100 Percent $464 7720%
Single Case Agreement $464 7720%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals