CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Adventist Health Castle

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $44
Cash Discount Price: $22
vs. Medicare Baseline: 7.32x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Adventist Health Castle is $44. 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 7.32x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$22

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $44 (732%)

Cash: $22 (366% of Medicare)

Ins. Median: $44 (732% 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 732% of the Medicare baseline (a markup of 632%). 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
Pacific Admin Ppo - All Plans	$3 - $11	50%
Uni Health Alliance - All Plans	$3 - $11	50%
Alohacare Quest Mcaid - All Other Plans	$4 - $44	67%
Devoted Hlth Mcr Adv - All Plans	$6	100%
Kfh Mcr Adv	$6	100%
Medicare (plans)	$6	100%
Ohana Health Plan - All Plans	$6	100%
UnitedHealthcare	$8	133%
Multiplan Hmn - All Plans	$9	150%
Hwmg/Hmaa - All Plans	$12 - $130	200%
Health Alliance - All Plans	$13 - $141	216%
Hmsa Hmo	$13	216%
Hmsa Ppo - All Other Plans	$13	216%
Kfh - All Other Plans	$13 - $150	216%
Mdx Hawaii Ppo - All Plans	$13 - $140	216%
First Health Ppo - All Plans	$15 - $165	250%
Medicaid / KanCare	$16 - $176	266%
State Of Hi Nonprofit - All Plans	$28 - $308	466%

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 Adventist Health Castle 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.