CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: St Marys Good Samaritan Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $17
Cash Discount Price: $32
vs. Medicare Baseline: 2.83x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at St Marys Good Samaritan Hospital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 2.83x the Medicare baseline. Located in 5401 Lake Oconee Parkway, Greensboro, GA.

Cash / Self-Pay

$32

Average discount available for prompt cash payment at this facility.

Insurance Median

$17

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: $32 (532%)

Insurance Median: $17 (283%)

Cash: $32 (532% of Medicare)

Ins. Median: $17 (283% 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 283% of the Medicare baseline (a markup of 183%). 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
Blue Cross Blue Shield	$7 - $46	116%
Amerigroup	$8	133%
Aetna	$10 - $50	166%
Ambetter / Centene	$10 - $17	166%
Care Improvement Plus	$10 - $17	166%
Caresource	$10 - $17	166%
Cigna	$10 - $52	166%
Coventry	$10 - $47	166%
Eon Health Plan	$10 - $17	166%
Humana	$10 - $47	166%
Kaiser Permanente	$10 - $17	166%
Molina	$10 - $17	166%
Pruitthealth Premier	$10 - $17	166%
Todays Options Pffs	$10 - $17	166%
Todays Options Ppo	$10 - $17	166%
UnitedHealthcare	$10 - $2,632	166%
Vaccn United	$10 - $17	166%
Wellcare	$10 - $17	166%
First Health	$27 - $47	449%
Phcs	$27 - $47	449%
Meritain	$29 - $50	483%
Multiplan	$31 - $55	516%
Nova	$31 - $57	516%
Three Rivers Provider Network	$32 - $57	532%

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 $32.
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 St Marys Good Samaritan 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.