CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Lost Rivers Medical Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $33
Cash Discount Price: $42
vs. Medicare Baseline: 5.49x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Lost Rivers Medical Center is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 5.49x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $42 (699%)

Insurance Median: $33 (549%)

Cash: $42 (699% of Medicare)

Ins. Median: $33 (549% 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 549% of the Medicare baseline (a markup of 449%). 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
Humana	$3 - $33	50%
Regence Blue Shield-All Other Plans	$3	50%
Provider Network Of America-All Plans	$11	183%
Select Health Brightpath-All Other Plans	$30	499%
Tricare	$30	499%
Ihcn Brightpath-All Other Plans	$32	532%
Va Pccc-All Plans	$32	532%
Blue Cross Blue Shield	$33 - $53	549%
Ihcn Brightpath Mcr Adv	$33	549%
Molina Mcr Adv-All Plans	$33	549%
Pacificsource Mcr Adv	$33	549%
Regence/Brightpth Slhp Mcr	$33	549%
Select Health Mcr Adv	$33	549%
Prime Hlth Mcr Adv	$35	582%
Aetna	$36 - $50	599%
Cigna	$49	815%
First Choice-All Plans	$49	815%
Pacificsource Navigator-All Other Plans	$50	832%
UnitedHealthcare	$50	832%
Altius Health Plan-All Plans	$51	849%

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 $42.
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 Lost Rivers 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.