Blood test, clotting time (PTT)
Facility: University of Michigan Health System
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $32
- Cash Discount Price: $27
- vs. Medicare Baseline: 5.32x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 532% of the Medicare baseline (a markup of 432%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $2 - $36 | 33% |
| Metrocare | $2 - $34 | 33% |
| Point Comfort Underwriters Unaccompanied Children Program | $2 - $31 | 33% |
| Priority Health [1038] | $2 - $48 | 33% |
| Aetna | $3 - $48 | 50% |
| Ambetter / Centene | $3 | 50% |
| Blue Cross Blue Shield | $3 - $32 | 50% |
| Buckeye Community Health Plan | $3 | 50% |
| Cofinity | $3 - $51 | 50% |
| Confinity Advantage | $3 - $48 | 50% |
| First Health | $3 - $57 | 50% |
| Hap Midwest | $3 | 50% |
| Hap [1023] | $3 - $54 | 50% |
| Mclaren Health Plan Inc | $3 - $47 | 50% |
| Molina Healthcare Of Michigan Inc | $3 - $6 | 50% |
| Plain Church Group | $3 - $43 | 50% |
| Priority Health | $3 - $72 | 50% |
| UnitedHealthcare | $3 - $53 | 50% |
| Beaumont Health Network | $4 - $50 | 67% |
| Bronson Healthcare Group | $4 - $61 | 67% |
| First Agency | $4 - $54 | 67% |
| Multiplan | $4 - $61 | 67% |
| Nomi Health | $4 - $50 | 67% |
| Paramount Health Care | $4 - $60 | 67% |
| Parkview Health Plan Services | $4 - $54 | 67% |
| Provider Network Of America | $4 - $50 | 67% |
| Amerihealth Michigan Inc | $6 | 100% |
| Blue Care Network Of Michigan | $6 - $32 | 100% |
| Health Alliance Plan | $6 | 100% |
| Humana | $6 | 100% |
| Huron Valley Pace | $6 | 100% |
| Medicare (plans) | $6 | 100% |
| Medigold Trinity Health Plan Of Michigan | $6 | 100% |
| Meridian Health Plan Of Michigan Inc | $6 | 100% |
| Paramount Elite-Ohio | $6 | 100% |
| Thome Pace | $6 | 100% |
| Triwest | $6 | 100% |
| Veteran Affairs Community Care Program | $6 | 100% |
| Zing Health | $6 | 100% |
| Employee Benefit Logistic | $10 | 166% |