CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Jacksonville Memorial Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $123
Cash Discount Price: $202
vs. Medicare Baseline: 20.47x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Jacksonville Memorial Hospital is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $202. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 20.47x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$202

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $202 (3361%)

Insurance Median: $123 (2047%)

Cash: $202 (3361% of Medicare)

Ins. Median: $123 (2047% 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 2047% of the Medicare baseline (a markup of 1947%). 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	$6 - $205	100%
Coventry	$6 - $32	100%
Health Alliance	$6 - $139	100%
Humana	$6 - $175	100%
Medicare (plans)	$6 - $32	100%
Tricare	$6 - $37	100%
UnitedHealthcare	$6 - $148	100%
Medicaid / KanCare	$7	116%
Molina Healthcare	$7	116%
Corvel/Corcare	$31 - $55	516%
Illinois Workers Compensation	$33 - $65	549%
Commercial Workers Compensation	$62	1032%
Health Alliance Mh Employee Plan	$92 - $94	1531%
Current Health Network	$109 - $154	1814%
6 Degrees Health	$119 - $123	1980%
Hope Trust	$119 - $123	1980%
Hst	$119 - $123	1980%
Cigna	$138 - $142	2296%
Aetna	$139 - $164	2313%
Healthlink	$169 - $174	2812%
Phcs/Multiplan	$179 - $184	2978%
Hfn	$189 - $195	3145%
Liability	$199 - $205	3311%

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 $202.
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 Jacksonville Memorial 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.