CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Atrium Health Navicent Peach

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $48
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 7.99x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Atrium Health Navicent Peach is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 7.99x the Medicare baseline. Located in 1960 Highway 247 Connector, Byron, GA.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $44 (732%)
Insurance Median: $48 (799%)
Cash: $44 (732% of Medicare)
Ins. Median: $48 (799% 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 799% of the Medicare baseline (a markup of 699%). 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
Blue Cross Blue Shield $7 - $18 116%
Cigna $13 - $64 216%
Humana $15 - $75 250%
Securehealth $16 - $57 266%
Aetna $17 - $52 283%
Georgia Health Advantage $18 300%
Pruitt Health $18 300%
UnitedHealthcare $18 - $55 300%
Care Source $19 316%
Clover $19 316%
Eon Health $19 316%
Ambetter / Centene $26 - $45 433%
Alliant $43 715%
Multiplan $57 - $70 948%
Novanet $70 1165%
Three Rivers Provider Network $75 1248%
Beechstreet $82 1364%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1960 Highway 247 Connector, Byron, GA 31008
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals