CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Pulaski Memorial Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $51
  • Cash Discount Price: $75
  • vs. Medicare Baseline: 8.49x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Pulaski Memorial Hospital is $51. 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 8.49x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.
Cash / Self-Pay
$75

Average discount available for prompt cash payment at this facility.

Insurance Median
$51

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: $51 (849%)
Cash: $75 (1248% of Medicare)
Ins. Median: $51 (849% 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 849% of the Medicare baseline (a markup of 749%). 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 $6 - $110 100%
Caresource Mcaid Hhw $6 100%
Cenpatico Mcaid Hhw - All Other Plans $6 100%
Mdwise Mcaid Hcc $6 100%
Mdwise Mcaid Hhw $6 100%
Mhs Mcaid Hhw/Hcc $6 100%
UnitedHealthcare $6 - $130 100%
Ambetter / Centene $22 - $51 366%
Caresource Mcaid Hip $22 - $51 366%
Caresource Mcare Hmo $22 - $51 366%
Cenpatico Mcaid Hip $22 - $51 366%
Mdwise Mcaid Hip - All Other Plans $22 - $51 366%
Mhs Mcaid Hip $22 - $51 366%
Humana $23 - $133 383%
Mhs Mcare Allwell $23 - $52 383%
Aetna $26 - $59 433%
Caresource Exch Hmo Hix - All Other Plans $28 - $64 466%
Sagamore Rose Acre $54 - $123 899%
Sagamore - All Other Plans $55 - $125 915%
Encore Ppo - All Other Plans $61 - $140 1015%
Community Health Alliance - All Plans $64 - $147 1065%
Encore Workers Comp $65 - $148 1082%
Multiplan - All Plans $65 - $148 1082%
Cigna $68 - $157 1131%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 616 E 13Th St, Winamac, IN 46996
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals