CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Valley West Community Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $66
  • Cash Discount Price: $75
  • vs. Medicare Baseline: 10.98x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Valley West Community Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 10.98x the Medicare baseline. Located in 11 East Pleasant Avenue, Sandwich, IL.
Cash / Self-Pay
$75

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $75 (1248%)
Insurance Median: $66 (1098%)
Cash: $75 (1248% of Medicare)
Ins. Median: $66 (1098% 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 1098% of the Medicare baseline (a markup of 998%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $14 - $108 233%
Global Excel [1712] $14 - $25 233%
Humana $14 - $25 233%
Aetna $19 - $91 316%
Health'S Finest Network [126] $33 - $112 549%
The Alliance [1703] $40 - $72 666%
Choicecare [177] $49 - $89 815%
Healthlink [125] $55 - $99 915%
Multiplan/Phcs [142] $58 - $132 965%
First Health Plan [6034] $73 - $132 1215%
UnitedHealthcare $73 - $132 1215%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11 East Pleasant Avenue, Sandwich, IL 60548
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals