CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Atrium Health Navicent Rehabilitation Hopsital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $17
Cash Discount Price: $59
vs. Medicare Baseline: 2.83x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Atrium Health Navicent Rehabilitation Hopsital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 2.83x the Medicare baseline. Located in 3351 Northside Dr, Macon, GA.

Cash / Self-Pay

$59

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: $59 (982%)

Insurance Median: $17 (283%)

Cash: $59 (982% 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
UnitedHealthcare	$4 - $23	67%
Aetna	$6 - $82	100%
Alliant	$6 - $7	100%
Blue Cross Blue Shield	$6 - $7	100%
Care Source	$6	100%
Clover	$6	100%
Eon Health	$6	100%
Georgia Health Advantage	$6	100%
Humana	$6 - $80	100%
Pruitt Health	$6	100%
Cigna	$8 - $16	133%
Kaiser	$9 - $21	150%
Ibg	$16 - $83	266%
Securehealth	$16 - $41	266%
Ambetter / Centene	$35 - $60	582%
Multiplan	$76 - $94	1265%
Novanet	$94	1564%
Three Rivers Provider Network	$99	1647%
Beechstreet	$109	1814%

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 $59.
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 Atrium Health Navicent Rehabilitation Hopsital 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.