CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Palm Bay Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $43
Cash Discount Price: $22
vs. Medicare Baseline: 7.15x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Palm Bay Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 7.15x the Medicare baseline. Located in 1425 Malabar Rd, Ne, Palm Bay, FL.

Cash / Self-Pay

$22

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $22 (366%)

Insurance Median: $43 (715%)

Cash: $22 (366% of Medicare)

Ins. Median: $43 (715% 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 715% of the Medicare baseline (a markup of 615%). 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 - $95	33%
Amerigroup	$2 - $86	33%
Humana	$2 - $86	33%
Molina Healthcare	$2 - $96	33%
Sunshine Health Plan	$2 - $90	33%
UnitedHealthcare	$2 - $86	33%
Corizon Health	$6	100%
Health First Health Plan	$6 - $26	100%
Florida Healthcare Plans	$27	449%
Cigna	$33 - $35	549%
Disney Cruise Line	$52	865%
Prime Heath Services, Inc.	$64	1065%
Multiplan	$69	1148%
Florida Blue	$382 - $402	6356%

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 $22.
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 Palm Bay 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.