CMS Price Transparency Data
Blood test, clotting time (PTT)
Facility: Mercy Health Saint Mary's
Billing Code: 85730 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85730
- Insurance Median: $20
- Cash Discount Price: $17
- vs. Medicare Baseline: 3.33x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Mercy Health Saint Mary's is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 3.33x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$17
Average discount available for prompt cash payment at this facility.
Insurance Median
$20
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: $17 (283%)
Insurance Median: $20 (333%)
Cash: $17 (283% of Medicare)
Ins. Median: $20 (333% 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 333% of the Medicare baseline (a markup of 233%). 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.
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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 - $8 | 50% |
| Medicaid / KanCare | $3 | 50% |
| Access Health | $4 | 67% |
| Aetna | $4 - $26 | 67% |
| Acs Benefit Services | $5 - $33 | 83% |
| Allied Benefit Systems | $5 - $33 | 83% |
| Claimchoice Adminstrators | $5 - $33 | 83% |
| Consociate | $5 - $33 | 83% |
| Cypress Benefit Administrators | $5 - $33 | 83% |
| Forest County Potawatomi | $5 - $33 | 83% |
| Health Smart | $5 - $33 | 83% |
| Healthgram | $5 - $33 | 83% |
| Healthscope | $5 - $33 | 83% |
| Nomi Health | $5 - $32 | 83% |
| Secureone Preferred United Plans | $5 - $33 | 83% |
| Sisco Benefits | $5 - $33 | 83% |
| The Health Plan | $5 - $33 | 83% |
| Trustmark Small Business Benefits | $5 - $33 | 83% |
| Unified Group Services | $5 - $33 | 83% |
| Wc Accident Fund | $5 - $32 | 83% |
| Wc Advantage | $5 - $32 | 83% |
| Wc Aig | $5 - $32 | 83% |
| Wc Allied | $5 - $32 | 83% |
| Wc Amerisure | $5 - $32 | 83% |
| Wc Amtrust | $5 - $32 | 83% |
| Wc Asu Risk Mgt | $5 - $32 | 83% |
| Wc Berkley Admin | $5 - $32 | 83% |
| Wc Broadspire | $5 - $32 | 83% |
| Wc Bunch & Associates | $5 - $32 | 83% |
| Wc Ccmsi | $5 - $32 | 83% |
| Wc Emc Insurance Company | $5 - $32 | 83% |
| Wc Esis | $5 - $32 | 83% |
| Wc Fcci | $5 - $32 | 83% |
| Wc Federated | $5 - $32 | 83% |
| Wc Gallagher Bassett | $5 - $32 | 83% |
| Wc Genex Care For Ohio | $5 - $32 | 83% |
| Wc Guard Insurance Company | $5 - $32 | 83% |
| Wc Hartford | $5 - $32 | 83% |
| Wc Liberty Mutual | $5 - $32 | 83% |
| Wc Meijers | $5 - $32 | 83% |
| Wc Michigan | $5 - $32 | 83% |
| Wc Mitchell Frankenmuth | $5 - $32 | 83% |
| Wc Pma | $5 - $32 | 83% |
| Wc Sedgwick | $5 - $32 | 83% |
| Wc Sentry | $5 - $32 | 83% |
| Wc Travelers | $5 - $32 | 83% |
| Wc Tristar | $5 - $32 | 83% |
| Wc Walmart | $5 - $32 | 83% |
| Wc Zurich | $5 - $32 | 83% |
| Webtpa | $5 - $33 | 83% |
| Align Senior Care | $6 | 100% |
| Asr Health Benefits | $6 - $37 | 100% |
| Blue Care Network Advantage | $6 | 100% |
| Caresource | $6 - $38 | 100% |
| Correctional Recovery | $6 | 100% |
| Hap | $6 - $45 | 100% |
| Hospice Faith | $6 | 100% |
| Hospice Of Holland | $6 | 100% |
| Medicare (plans) | $6 | 100% |
| Oscar | $6 | 100% |
| UnitedHealthcare | $6 - $58 | 100% |
| Varipro | $6 - $38 | 100% |
| 1199 National Benefit Fund | $7 - $42 | 116% |
| Acclaim | $7 - $44 | 116% |
| Administrative Concepts | $7 - $44 | 116% |
| Allegeant | $7 - $44 | 116% |
| Allied National Global Care | $7 - $42 | 116% |
| Ameriben | $7 - $44 | 116% |
| American Family | $7 - $44 | 116% |
| American Healthcare Alliance | $7 - $44 | 116% |
| American Republic | $7 - $44 | 116% |
| Amerihealth | $7 - $44 | 116% |
| Asrm - Reliance Standard Life Insurance | $7 - $42 | 116% |
| Aultcare | $7 - $44 | 116% |
| Automated Benefit Services | $7 - $44 | 116% |
| Auxiant | $7 - $44 | 116% |
| Benefit Administrative Systems,Llc | $7 - $44 | 116% |
| Boon Chapman | $7 - $44 | 116% |
| Cam Administrative Services | $7 - $44 | 116% |
| Christian Brother Services | $7 - $44 | 116% |
| Christian Brothers Holy Cross | $7 - $44 | 116% |
| Christian Care Ministry | $7 - $42 | 116% |
| Cigna | $7 - $42 | 116% |
| Comprehensive Benefits | $7 - $44 | 116% |
| Continental Life Insurance | $7 - $44 | 116% |
| Coventry | $7 - $46 | 116% |
| Custom Benefit Administrators | $7 - $44 | 116% |
| Dean Health | $7 - $42 | 116% |
| Employee Benefit Concepts | $7 - $44 | 116% |
| Employee Benefit Management | $7 - $44 | 116% |
| Enterprise Group Planning | $7 - $44 | 116% |
| Fallon Health | $7 - $42 | 116% |
| Family Life Insurance Company | $7 - $42 | 116% |
| First Health | $7 - $46 | 116% |
| Freedom Life Insurance Company | $7 - $44 | 116% |
| Geha | $7 - $44 | 116% |
| Ghc Scw | $7 - $42 | 116% |
| Group Administrators | $7 - $44 | 116% |
| Group Marketing Services | $7 - $44 | 116% |
| Group Pension Administrators | $7 - $42 | 116% |
| Guardian | $7 - $44 | 116% |
| Health America | $7 - $44 | 116% |
| Health Choices | $7 - $44 | 116% |
| Healthez | $7 - $44 | 116% |
| Humana | $7 - $58 | 116% |
| Insight | $7 - $44 | 116% |
| Intercare | $7 - $44 | 116% |
| International Benefit Administrators | $7 - $42 | 116% |
| Jfp Benefit Management | $7 - $44 | 116% |
| Jp Farley Corporation | $7 - $44 | 116% |
| Key Benefit Administrator | $7 - $44 | 116% |
| Liberty Union Life Assurance Co | $7 - $44 | 116% |
| Lifetime Benefit Solutions | $7 - $42 | 116% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $7 | 116% |
| Lucent Health | $7 - $44 | 116% |
| Luminare Health | $7 - $44 | 116% |
| Luminare Health (Detroit) | $7 - $44 | 116% |
| Manhattan Life | $7 - $42 | 116% |
| Medben | $7 - $44 | 116% |
| Medcost | $7 - $44 | 116% |
| Medi Share | $7 - $42 | 116% |
| Multiplan | $7 - $42 | 116% |
| Mutual Health Services | $7 - $44 | 116% |
| Mutual Of Omaha | $7 - $44 | 116% |
| Mvp | $7 - $42 | 116% |
| Ncas | $7 - $44 | 116% |
| Nippon Life Ins | $7 - $44 | 116% |
| Nova | $7 - $44 | 116% |
| Pai | $7 - $42 | 116% |
| Painters Union Insurance Fund | $7 - $44 | 116% |
| Pan-American Life | $7 - $42 | 116% |
| Paramount Hmo | $7 - $42 | 116% |
| Phcs | $7 - $42 | 116% |
| Physicians Mutual | $7 - $44 | 116% |
| Plumbers Local 98 Insurance Fund | $7 - $44 | 116% |
| Prairie States | $7 - $44 | 116% |
| Primary Physician Care | $7 - $44 | 116% |
| Professional Benefit Administrators | $7 - $44 | 116% |
| The Loomis Company | $7 - $44 | 116% |
| Trinity Health Share | $7 - $42 | 116% |
| U Of M Health Plan | $7 - $44 | 116% |
| Unicare | $7 - $44 | 116% |
| Us Health And Life | $7 - $44 | 116% |
| Valenz | $7 - $44 | 116% |
| Western & Southern Financial Group | $7 - $44 | 116% |
| Wps | $7 - $44 | 116% |
| Bcn Domestic | $8 | 133% |
| Blue Benefit Administrators Of Massachusetts | $8 | 133% |
| Blue Care Network | $8 | 133% |
| Blue Distinction Transplant | $8 | 133% |
| Blue Shield - Ca | $8 | 133% |
| Blue Shield - Id (Regence) | $8 | 133% |
| Blue Shield - Ny Highmark Northeastern | $8 | 133% |
| Blue Shield - Ny Highmark Western | $8 | 133% |
| Blue Shield - Pa (Highmark) | $8 | 133% |
| Blue Shield - Wa (Regence) | $8 | 133% |
| Kaiser Domestic | $8 | 133% |
| Molina Marketplace | $8 | 133% |
| Cmh Allegan County | $9 - $58 | 150% |
| Cmh Ausable Valley | $9 - $58 | 150% |
| Cmh Barry County | $9 - $58 | 150% |
| Cmh Berrien County | $9 - $58 | 150% |
| Cmh Cass County | $9 - $58 | 150% |
| Cmh Clinton-Eaton-Ingham County | $9 - $58 | 150% |
| Cmh Kalamazoo | $9 - $58 | 150% |
| Cmh Kent County | $9 - $58 | 150% |
| Cmh Lenawee County | $9 - $58 | 150% |
| Cmh Misc | $9 - $58 | 150% |
| Cmh Monroe County | $9 - $58 | 150% |
| Cmh Montcalm County | $9 - $58 | 150% |
| Cmh Muskegon County | $9 - $58 | 150% |
| Cmh Newaygo County | $9 - $58 | 150% |
| Cmh North Country | $9 - $58 | 150% |
| Cmh Northern Lakes County | $9 - $58 | 150% |
| Cmh Ottawa County | $9 - $58 | 150% |
| Cmh Van Buren County | $9 - $58 | 150% |
| Cmh West Mi County | $9 - $58 | 150% |
| Magellan Behavioral Health | $9 - $58 | 150% |
| Medical Mutual | $9 | 150% |
| Meritain | $9 | 150% |
| Preferred One | $9 | 150% |
| Vitalcore | $9 | 150% |
| Wellpath | $9 | 150% |
| Priority Health | $36 - $37 | 599% |