CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Rockcastle County Hospital, Inc.

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $98
  • Cash Discount Price: $98
  • vs. Medicare Baseline: 16.31x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Rockcastle County Hospital, Inc. is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 16.31x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.
Cash / Self-Pay
$98

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

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: $98 (1631%)
Insurance Median: $98 (1631%)
Cash: $98 (1631% of Medicare)
Ins. Median: $98 (1631% 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 1631% of the Medicare baseline (a markup of 1531%). 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 $5 - $223 83%
Tricare $5 83%
Caresource Mcr Adv-All Other Plans $6 100%
Humana $6 100%
Molina Marketplace - All Other Plans $6 100%
Molina Mcr Adv $6 100%
Signature Mcr Adv-All Plans $6 100%
Wellcare Mcr Adv-All Other Plans $6 100%
Passport Hp Hmo - All Plans $26 - $87 433%
Multiplan-All Plans $82 - $275 1364%
Prime Health Services-All Plans $82 - $275 1364%
Integrated Hp-All Plans $86 - $287 1431%
Corvel - All Plans $87 - $291 1448%
Center Care-All Plans $92 - $307 1531%
Cigna $94 - $313 1564%
Caresource Mcaid $97 - $323 1614%
Coventry Mcaid-All Plans $97 - $323 1614%
Medicaid / KanCare $97 - $323 1614%
Molina Mcaid $97 - $323 1614%
UnitedHealthcare $97 - $323 1614%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 145 Newcomb Avenue, Mount Vernon, KY 40456
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals