CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Northwestern Medicine Central Dupage Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $63
Cash Discount Price: $78
vs. Medicare Baseline: 10.48x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Northwestern Medicine Central Dupage Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 10.48x the Medicare baseline. Located in 25 North Winfield Road, Winfield, IL.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

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: $78 (1298%)

Insurance Median: $63 (1048%)

Cash: $78 (1298% of Medicare)

Ins. Median: $63 (1048% 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 1048% of the Medicare baseline (a markup of 948%). 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	$3 - $211	50%
Countycare Il Cook Co [1607]	$3 - $15	50%
Medicaid / KanCare	$3 - $15	50%
Aetna	$6 - $74	100%
Carelon Behavioral Health [159]	$20 - $106	333%
Health'S Finest Network [126]	$20 - $192	333%
Multiplan/Phcs [142]	$23 - $211	383%
Dreyer Med Ipa Advocate [1409]	$24 - $127	399%
Humana	$24 - $211	399%
Magellan Behavioral Hlth [136]	$24 - $127	399%
Healthlink [125]	$25 - $133	416%
Choicecare [177]	$31 - $162	516%
First Health Plan [6034]	$31 - $162	516%
Cigna	$32 - $169	532%
Compsych [112]	$32 - $169	532%
UnitedHealthcare	$40 - $211	666%

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 $78.
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 Northwestern Medicine Central Dupage 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.