CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Mercyone Elkader Medical Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $73
  • Cash Discount Price: $741
  • vs. Medicare Baseline: 12.15x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Mercyone Elkader Medical Center is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $741. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 12.15x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.
Cash / Self-Pay
$741

Average discount available for prompt cash payment at this facility.

Insurance Median
$73

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: $741 (12329%)
Insurance Median: $73 (1215%)
Cash: $741 (12329% of Medicare)
Ins. Median: $73 (1215% 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 1215% of the Medicare baseline (a markup of 1115%). 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
Aetna $6 - $73 100%
Iowa Dept Of Public Health $9 - $99 150%
Blue Cross Blue Shield $51 849%
Medicare (plans) $52 - $53 865%
UnitedHealthcare $55 - $74 915%
Iowa Total Care $62 1032%
Medicaid / KanCare $62 - $63 1032%
Amish Hospital Aid $68 1131%
1199 National Benefit Fund $73 1215%
Allied Benefit Systems $73 1215%
Asr Health Benefits $73 1215%
Christian Brother Services $73 1215%
Coventry $73 1215%
First Health $73 1215%
Lucent Health $73 1215%
Luminare Health $73 1215%
Medical Mutual $73 1215%
Meritain $73 1215%
Trustmark Small Business Benefits $73 1215%
Webtpa $73 1215%
Geha $74 1231%
Centivo $77 1281%
Health Choices $79 1314%
Medical Associates $79 1314%
Ambetter / Centene $86 1431%
Health Partners $95 1581%
Auxiant $97 1614%
Cigna $97 1614%
Medica $97 1614%
Midlands $97 1614%
Midlands Choice $97 1614%
Crime Victim Assistance $99 1647%
Claimdoc $103 1714%
Nova $103 1714%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 Davidson Street Nw, Elkader, IA 52043
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals