CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Tj Health Columbia

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $63
Cash Discount Price: $59
vs. Medicare Baseline: 10.48x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Tj Health Columbia is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 10.48x the Medicare baseline. Located in 901 Westlake Drive, Columbia, KY.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

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: $59 (982%)

Insurance Median: $63 (1048%)

Cash: $59 (982% of Medicare)

Ins. Median: $63 (1048% 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 1048% of the Medicare baseline (a markup of 948%). 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
Caresource - All Plans	$2 - $19	33%
Blue Cross Blue Shield	$5 - $322	83%
Devoted Mcr Adv - All Plans	$6	100%
Humana	$6 - $322	100%
Molina Mcr Adv	$6	100%
Signature Advantage - All Plans	$6	100%
Molina Marketplace - All Other Plans	$9	150%
UnitedHealthcare	$20 - $161	333%
Center Care Select - All Plans	$22 - $177	366%
First Health - All Plans	$38 - $306	632%
Phcs/Multiplan - All Plans	$38 - $303	632%
Aetna	$40 - $322	666%
Molina Mcaid	$41 - $332	682%

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 $59.
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 Tj Health Columbia 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.