CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Mainehealth Maine Medical Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $71
Cash Discount Price: $112
vs. Medicare Baseline: 11.81x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Mainehealth Maine Medical Center is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 11.81x the Medicare baseline. Located in 22 Bramhall St, Portland, ME.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $112 (1864%)

Insurance Median: $71 (1181%)

Cash: $112 (1864% of Medicare)

Ins. Median: $71 (1181% 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 1181% of the Medicare baseline (a markup of 1081%). 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	$3 - $61	50%
Aetna	$6 - $153	100%
Harvard Pilgrim Healthcare	$6 - $159	100%
Humana	$6 - $26	100%
UnitedHealthcare	$6 - $166	100%
Wellcare	$6 - $27	100%
Community Health Options	$12 - $155	200%
Cigna	$64 - $153	1065%
Multiplan	$71 - $167	1181%

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 $112.
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 Mainehealth Maine Medical Center 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.