CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Norton Scott Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $53
Cash Discount Price: $43
vs. Medicare Baseline: 8.82x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Norton Scott Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 8.82x the Medicare baseline. Located in 1451 N Gardner St, Scottsburg, IN.

Cash / Self-Pay

$43

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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: $43 (715%)

Insurance Median: $53 (882%)

Cash: $43 (715% of Medicare)

Ins. Median: $53 (882% 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 882% of the Medicare baseline (a markup of 782%). 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	$5 - $127	83%
Caresource Indiana Healthy Indiana Plan (Hip)	$6	100%
Caresource Indiana Hoosier Healthwise (Hhw)	$6	100%
Caresource Indiana Just4Me	$6	100%
Managed Health Services (Mhs)	$6 - $52	100%
Managed Health Services (Mhs) Hoosier Care Connect	$6	100%
Mdwise Hoosier Healthwise (Hhw)	$6	100%
Molina Healthcare	$6	100%
UnitedHealthcare	$6 - $129	100%
Managed Health Services (Mhs) Healthy Indiana Plan (Hip)	$52	865%
Mdwise Healthy Indiana Plan (Hip)	$52	865%
Communicare Advantage	$53	882%
Aetna	$136	2263%
Multiplan	$173 - $184	2879%
Cigna	$184	3062%
Encore Health Network	$184	3062%
Prime Health	$184	3062%
Ppom	$190	3161%
Intercommunity Health Network (Ihn)	$194	3228%

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 $43.
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 Norton Scott 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.