CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Witham Health Services

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $140
Cash Discount Price: $142
vs. Medicare Baseline: 23.29x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Witham Health Services is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 23.29x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.

Cash / Self-Pay

$142

Average discount available for prompt cash payment at this facility.

Insurance Median

$140

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: $142 (2363%)

Insurance Median: $140 (2329%)

Cash: $142 (2363% of Medicare)

Ins. Median: $140 (2329% 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 2329% of the Medicare baseline (a markup of 2229%). 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	$6 - $150	100%
Blue Cross Blue Shield	$6 - $160	100%
Caresource Indiana Marketplace-All Other Plans	$6	100%
Caresource Mcr Adv	$6	100%
Mdwise Health In-All Plans	$6	100%
UnitedHealthcare	$132	2196%
Phcs/Multiplan-All Plans	$184	3062%
Sagamore-All Plans	$186	3095%
Humana	$188	3128%
Beech Street-All Plans	$190	3161%
Encore-All Plans	$193	3211%
Mhs Comml Exch-All Plans	$507	8436%

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 $142.
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 Witham 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.