CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Northside Hospital Cherokee

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $45
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 7.49x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Northside Hospital Cherokee is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 7.49x the Medicare baseline. Located in 450 Northside Cherokee Boulevard, Canton, GA.
Cash / Self-Pay
$49

Average discount available for prompt cash payment at this facility.

Insurance Median
$45

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: $49 (815%)
Insurance Median: $45 (749%)
Cash: $49 (815% of Medicare)
Ins. Median: $45 (749% 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 749% of the Medicare baseline (a markup of 649%). 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
Fairly Group $5 83%
Aetna $6 - $107 100%
Bccp $6 100%
Blue Cross Blue Shield $6 - $374 100%
Caresource $6 - $200 100%
Cbww $6 100%
Champus Va $6 100%
Clear Springs Eon Health $6 100%
Clover Health $6 100%
Coventry $6 - $365 100%
Humana $6 100%
Kaiser $6 - $467 100%
Medicaid / KanCare $6 - $7 100%
Medicare (plans) $6 - $7 100%
Pruitt Health Premier $6 100%
Tricare $6 100%
UnitedHealthcare $6 - $86 100%
Va Ccn $6 100%
Wellcare $6 100%
Ambetter / Centene $7 - $103 116%
Amerigroup $7 - $80 116%
Cigna $7 - $338 116%
Us Dept Of Labor Wc $8 133%
Corvel Workers Comp $9 150%
Employers Choice Network $9 150%
Oscar $9 150%
Streamline Imaging $9 150%
Georgia Workers Compensation $10 166%
Northside Health Network $15 - $161 250%
Georgia Reproductive Specialists $20 - $215 333%
Medlien Healthcare Services $20 - $215 333%
Med Care Solutions $22 - $242 366%
Health One Alliance_Ppo $27 - $295 449%
Quick Trip $27 - $295 449%
Novanet_Ppo $34 - $376 566%
Phcs $37 - $403 616%
Beech Steet $42 - $456 699%
Multiplan $42 - $456 699%
Multiplan Workers Comp $42 - $456 699%
Careiq $49 - $537 815%
Cherokee County Board Of Health $49 - $537 815%
Dekalb_Department Of Health $49 - $537 815%
Fifa $49 - $537 815%
Institutional Marietta Surgery Center $49 - $537 815%
Institutional Veterans Evaluation Services $49 - $537 815%
Rabun County Boc $49 - $537 815%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 450 Northside Cherokee Boulevard, Canton, GA 30115
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals