CMS Price Transparency Data
Blood test, clotting time (PTT)
Facility: Palmetto General Hospital
Billing Code: 85730 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85730
- Insurance Median: $7
- Cash Discount Price: $475
- vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Palmetto General Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $475. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.16x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$475
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: $475 (7903%)
Insurance Median: $7 (116%)
Cash: $475 (7903% 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.
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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 - $193 | 33% |
| Medicaid / KanCare | $2 - $475 | 33% |
| UnitedHealthcare | $2 - $6 | 33% |
| Cigna | $3 - $238 | 50% |
| Veterans Administration Mill Bill | $4 | 67% |
| Avmed Broad Network | $5 | 83% |
| Medicare (plans) | $5 - $475 | 83% |
| Aetna | $6 - $337 | 100% |
| Bristol Hospice- Miami Dade Llc | $6 | 100% |
| Catholic Hospice | $6 | 100% |
| Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc | $6 | 100% |
| Devoted Health | $6 | 100% |
| Employer Direct Healthcare | $6 - $8 | 100% |
| Healthsun Health Plans | $6 | 100% |
| Hospice Other | $6 | 100% |
| Ima Evalutations Inc | $6 | 100% |
| Leon Health Inc | $6 | 100% |
| Longevity Health Plan | $6 | 100% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $6 | 100% |
| Opuscare Of South Fl | $6 | 100% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $6 | 100% |
| Select Specialty Hospital | $6 | 100% |
| Tricare | $6 | 100% |
| Veterans Administration Vaccn | $6 | 100% |
| Vitas Healthcare Hospice | $6 | 100% |
| Westchester General Hospital | $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 | $68 | 1131% |
| Bc/Bs Of Fl Network Blue | $68 | 1131% |
| Bc/Bs Of Fl Simplyblue | $68 | 1131% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $73 | 1215% |
| Bc/Bs Of Fl Health Options Hmo | $73 | 1215% |
| Bc/Bs Of Fl Ppo | $73 | 1215% |
| Bc/Bs Of Fl Miami Dade Blue Select | $96 | 1597% |
| Bc/Bs Of Fl Phs | $238 | 3960% |
| Liga Contra El Cancer | $238 | 3960% |
| Magellan Behavioral Health | $285 | 4742% |
| Dimensions International | $309 | 5141% |
| First Health | $318 | 5291% |
| Dimension Health Ppo | $356 | 5923% |
| Beacon Health Strategies Commercial | $475 | 7903% |
| Commercial Non-Contracted | $475 | 7903% |
| Self Pay - Mcd Pending 100 Percent | $475 | 7903% |
| Single Case Agreement | $475 | 7903% |
| United Behavioral Health Psych | $475 | 7903% |