CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Norton-King's Daughters' Health

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $36
  • Cash Discount Price: $13
  • vs. Medicare Baseline: 5.99x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Norton-King's Daughters' Health is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 5.99x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.
Cash / Self-Pay
$13

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $13 (216%)
Insurance Median: $36 (599%)
Cash: $13 (216% of Medicare)
Ins. Median: $36 (599% 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 599% of the Medicare baseline (a markup of 499%). 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
Aetna $5 - $70 83%
Blue Cross Blue Shield $6 - $18 100%
Humana $6 100%
Managed Health Services $6 - $9 100%
Managed Health Services Of Indiana $6 100%
Managed Health Services Of Kentucky $6 100%
Passport By Molina $6 100%
UnitedHealthcare $6 - $63 100%
Caresource Of Kentucky $8 133%
Caresource Of Indiana $9 150%
Custom Design Benefits $12 - $40 200%
Cigna $34 - $68 566%
Encore $34 - $68 566%
Bluegrass $36 - $72 599%
First Health $36 - $72 599%
Healthlink $36 - $72 599%
Quality Care Partners $36 - $71 599%
Vha/Tristate $36 - $72 599%
Multiplan/Phcs $37 - $74 616%
Indiana Health Network $38 - $76 632%
Siho $38 - $76 632%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1373 East Sr 62, Madison, IN 47250
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals