CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $7
Cash Discount Price: $50
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at UMass Memorial Healthalliance Hospitals is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.16x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $50 (832%)

Insurance Median: $7 (116%)

Cash: $50 (832% of Medicare)

Ins. Median: $7 (116% 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.

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
Institution [10406]	$5 - $26	83%
Masshealth [20302]	$5	83%
Medicaid / KanCare	$5 - $7	83%
Aetna	$6 - $33	100%
Blue Cross Blue Shield	$6 - $19	100%
Cigna	$6 - $23	100%
Commonwealth Care Mcr [10115]	$6	100%
Fallon Mcr Supp [20202]	$6	100%
Harvard Pilgrim Mcr [10106]	$6	100%
Medicare (plans)	$6	100%
Mgb Mcr [10124]	$6	100%
Senior Whole Health [10110]	$6	100%
Tufts Dual [10111]	$6	100%
Tufts Mcr [10112]	$6	100%
Tufts Us Family [11203]	$6	100%
UnitedHealthcare	$6 - $50	100%
Champva [11001]	$7	116%
Correctional Care [11003]	$8 - $10	133%
Workers Compensation [20501]	$8	133%
Tufts Connectorcare [10507]	$10	166%
Tufts [11201]	$13	216%
Harvard Pilgrim [10701]	$14 - $17	233%
Wellpoint [11112]	$16	266%
Hne [11108]	$28	466%
First Health Network [11120]	$38	632%
Multiplan [11109]	$38	632%
Fallon Connectorcare [10503]	$48	799%
Connecticare [11105]	$50	832%
Fallon Carelon Hlth [28]	$50	832%
Fallon Mcaid Carelon Hlth [29]	$50	832%
Grants [20507]	$50	832%
Hsno/Free Care [10801]	$294	4892%

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 $50.
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 UMass Memorial Healthalliance Hospitals 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.