CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Warner Hospital and Health Services

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $59
Cash Discount Price: $114
vs. Medicare Baseline: 9.82x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Warner Hospital and Health Services is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 9.82x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$114

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $114 (1897%)

Insurance Median: $59 (982%)

Cash: $114 (1897% of Medicare)

Ins. Median: $59 (982% 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 982% of the Medicare baseline (a markup of 882%). 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
Aetna	$14 - $240	233%
Blue Cross Blue Shield	$14 - $277	233%
Harmony Hp Mcaid-All Plans	$14	233%
Medicaid / KanCare	$14	233%
Meridian Hp-All Plans	$14	233%
Molina-All Other Plans	$14	233%
Health Alliance Med Adv	$22 - $116	366%
Humana	$22 - $240	366%
Molina Mcr/Mcd Dual	$22 - $116	366%
UnitedHealthcare	$22 - $240	366%
Wellcare Mcr Adv-All Plans	$22 - $116	366%
Healthlink Hmo	$42 - $221	699%
City Of Clinton (Employees Serv)-All Plans	$43 - $226	715%
Cigna	$45 - $235	749%
Caterpillar-All Plans	$46 - $240	765%
Multiplan Phcs-All Plans	$46 - $240	765%
Health Alliance-All Other Plans	$47 - $249	782%
Healthlink Ppo/Work Comp-All Other Plans	$47 - $249	782%
Consociate Care Ppo-All Plans	$48 - $255	799%
Hfn Ppo/Epo-All Plans	$48 - $255	799%
Three Rivers-All Plans	$51 - $269	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 $114.
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 Warner Hospital and Health Services 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.