CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $10
Cash Discount Price: $49
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at UMass Memorial Health - Harrington Hospital is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.66x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$49

Average discount available for prompt cash payment at this facility.

Insurance Median

$10

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: $49 (815%)

Insurance Median: $10 (166%)

Cash: $49 (815% of Medicare)

Ins. Median: $10 (166% 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
Masshealth [20302]	$5	83%
Medicaid / KanCare	$5 - $6	83%
Aetna	$6 - $49	100%
Blue Cross Blue Shield	$6 - $19	100%
Cigna	$6 - $35	100%
Commonwealth Care Alliance [10103]	$6	100%
Fallon Mcr Supp [20202]	$6	100%
Fallon Mcr [10105]	$6	100%
Institution [10406]	$6	100%
Mgb Mcr [10124]	$6	100%
Senior Whole Health [10110]	$6	100%
Tufts Mcr [10112]	$6	100%
Tufts Us Family [11203]	$6	100%
UnitedHealthcare	$6 - $49	100%
Champva [11001]	$7	116%
Workers Compensation [20501]	$8	133%
Tufts Connectorcare [10507]	$10	166%
Wellpoint [11112]	$16	266%
Harvard Pilgrim [10701]	$22 - $27	366%
Hne [11108]	$32	532%
Tufts [11201]	$35	582%
First Health Network [11120]	$37	616%
Evernorth Behavioral Health [27]	$39	649%
Fallon Connectorcare [10503]	$48	799%
Connecticare [11105]	$49	815%
Fallon Carelon Hlth [28]	$49	815%
Fallon Mcaid Carelon Hlth [29]	$49	815%
Grants [20507]	$49	815%
Masshealth Mcd Mbhp [38]	$49	815%
Wellsense Mcaid Carelon Hlth [21]	$49	815%
Hsno/Free Care [10801]	$681	11331%

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 $49.
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 Health - Harrington 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.