CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Mercyone Dyersville Medical Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $82
Cash Discount Price: $221
vs. Medicare Baseline: 13.64x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Mercyone Dyersville Medical Center is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $221. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 13.64x the Medicare baseline. Located in 1111 3Rd Street Sw, Dyersville, IA.

Cash / Self-Pay

$221

Average discount available for prompt cash payment at this facility.

Insurance Median

$82

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: $221 (3677%)

Insurance Median: $82 (1364%)

Cash: $221 (3677% of Medicare)

Ins. Median: $82 (1364% 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 1364% of the Medicare baseline (a markup of 1264%). 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
Iowa Dept Of Public Health	$9 - $99	150%
Health Choices	$37	616%
Blue Cross Blue Shield	$55	915%
Medicare (plans)	$56 - $61	932%
UnitedHealthcare	$59 - $69	982%
The Alliance	$60	998%
Geha	$69	1148%
Iowa Total Care	$69	1148%
Medicaid / KanCare	$70	1165%
Amish Hospital Aid	$74	1231%
1199 National Benefit Fund	$82	1364%
Aetna	$82	1364%
Allied Benefit Systems	$82	1364%
Asr Health Benefits	$82	1364%
Christian Brother Services	$82	1364%
Coventry	$82	1364%
First Health	$82	1364%
Luminare Health	$82	1364%
Medical Mutual	$82	1364%
Meritain	$82	1364%
Trustmark Small Business Benefits	$82	1364%
Webtpa	$82	1364%
Auxiant	$89	1481%
Cigna	$89	1481%
Medica	$89	1481%
Midlands	$89	1481%
Midlands Choice	$89	1481%
Multiplan	$89	1481%
Ambetter / Centene	$93	1547%
Crime Victim Assistance	$99	1647%
Claimdoc	$111	1847%
Nova	$111	1847%

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 $221.
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 Mercyone Dyersville Medical Center 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.