CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Palos Community Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $83
Cash Discount Price: $77
vs. Medicare Baseline: 13.81x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Palos Community Hospital is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 13.81x the Medicare baseline. Located in 12251 South 80Th Avenue, Palos Heights, IL.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$83

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: $77 (1281%)

Insurance Median: $83 (1381%)

Cash: $77 (1281% of Medicare)

Ins. Median: $83 (1381% 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 1381% of the Medicare baseline (a markup of 1281%). 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	$15 - $119	250%
Aetna	$20 - $119	333%
Carelon Behavioral Health [159]	$46 - $60	765%
Healthlink [125]	$46 - $119	765%
Magellan Behavioral Hlth [136]	$56 - $71	932%
Multiplan/Phcs [142]	$65 - $119	1082%
Compsych [112]	$70 - $89	1165%
First Health Plan [6034]	$70 - $89	1165%
Beechstreet [176]	$74 - $95	1231%
Cigna	$74 - $119	1231%
Health'S Finest Network [126]	$79 - $101	1314%
Galaxy Health Network [220]	$93 - $119	1547%
Global Excel [1712]	$93 - $119	1547%
Health Alliance [181]	$93 - $119	1547%
UnitedHealthcare	$93 - $119	1547%

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 $77.
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 Palos Community Hospital 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.