CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: St Luke's McCall

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $16
Cash Discount Price: $27
vs. Medicare Baseline: 2.66x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at St Luke's McCall is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 2.66x the Medicare baseline. Located in 1000 State Street, McCall, ID.

Cash / Self-Pay

$27

Average discount available for prompt cash payment at this facility.

Insurance Median

$16

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: $27 (449%)

Insurance Median: $16 (266%)

Cash: $27 (449% of Medicare)

Ins. Median: $16 (266% 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 266% of the Medicare baseline (a markup of 166%). 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	$8 - $42	133%
Commercial [1028]	$8 - $46	133%
Medicare (plans)	$8 - $28	133%
Veterans Affairs [1056]	$8 - $28	133%
Aetna	$9 - $45	150%
Moda [1055]	$12 - $42	200%
Cigna	$13 - $44	216%
Pacificsource [1020]	$13 - $45	216%
Providence [1022]	$13 - $44	216%
First Health [1064]	$14 - $45	233%
Geha [1065]	$14 - $46	233%
United Medical Resources [1051]	$14 - $46	233%
UnitedHealthcare	$14 - $46	233%
Webtpa [1071]	$14 - $45	233%

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 $27.
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 Luke's McCall 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.