Blood test, clotting time (PTT)
Facility: Dupont Hospital LLC
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $15
- Cash Discount Price: $40
- vs. Medicare Baseline: 2.50x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 250% of the Medicare baseline (a markup of 150%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Amish Aid | $2 - $46 | 33% |
| Lutheran Preferred | $2 - $102 | 33% |
| Self Pay | $2 - $76 | 33% |
| Aetna | $3 - $76 | 50% |
| Blue Cross Blue Shield | $3 - $10 | 50% |
| Cigna | $3 - $62 | 50% |
| Physicians Health Plan | $3 - $66 | 50% |
| Encore Ppo | $4 - $85 | 67% |
| Lutheran Network | $4 - $85 | 67% |
| Medical Mutual Of Oh | $4 - $90 | 67% |
| UnitedHealthcare | $4 - $82 | 67% |
| Sagamore | $5 - $95 | 83% |
| Caresource | $6 | 100% |
| Department Of Veterans Affairs | $6 | 100% |
| Humana | $6 | 100% |
| In Dept Of Correction | $6 | 100% |
| Iu Health | $6 | 100% |
| Managed Health Services | $6 - $12 | 100% |
| Medicaid / KanCare | $6 | 100% |
| Medicare (plans) | $6 | 100% |
| Node Devoted Health Mcr Adv | $6 | 100% |
| Node Mhs Mcr Adv | $6 | 100% |
| Node Non Par Hospice Agree | $6 | 100% |
| Node Pphp Mcr Adv | $6 | 100% |
| Node Va | $6 | 100% |
| Prime Health Services | $6 - $128 | 100% |
| Tricare | $6 | 100% |
| Veterans Eval Services | $6 | 100% |
| Advantage Health Solutions | $7 - $141 | 116% |
| Encore Health Network | $7 - $153 | 116% |
| Frontpath | $7 - $136 | 116% |
| Multiplan | $7 - $153 | 116% |
| Allied Benefit Systems | $8 - $153 | 133% |
| Php Freedom Network | $8 - $11 | 133% |
| Us Department Of Labor | $8 | 133% |
| Lutheran Advanced Network | $9 | 150% |
| Lutheran Preferred Fixed 2 | $9 | 150% |
| Align In Work Comp | $10 | 166% |
| Encore Work Comp In | $11 | 183% |
| In Work Comp | $12 | 200% |
| Encore Kba Epo | $14 | 233% |
| Encore Kba Ppo | $18 | 300% |