CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Barnes Jewish Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $104
Cash Discount Price: $99
vs. Medicare Baseline: 17.30x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Barnes Jewish Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 17.30x the Medicare baseline. Located in One Barnes-Jewish Hospital Plaza, Saint Louis, MO.

Cash / Self-Pay

$99

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $99 (1647%)

Insurance Median: $104 (1730%)

Cash: $99 (1647% of Medicare)

Ins. Median: $104 (1730% 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 1730% of the Medicare baseline (a markup of 1630%). 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
UnitedHealthcare	$6 - $123	100%
Healthscope Benefits [258]	$7 - $107	116%
Cigna	$8 - $132	133%
Consociate [478]	$11	183%
Sarah Bush Lincoln [636]	$11	183%
Aetna	$12 - $124	200%
Allied Benefits [498]	$12 - $123	200%
Coresource [497]	$12	200%
Fmh Benefit Service Inc [222]	$12	200%
Mail Handlers [495]	$12	200%
Apwu Health Plan [216]	$14	233%
Nalc Health Benefit Plan [242]	$14	233%
Priority Health [648]	$14	233%
Blue Cross Blue Shield	$19 - $144	316%
Humana	$20	333%
Mercy Behavioral Health [573]	$41	682%
Healthlink [225]	$80 - $125	1331%
Cox Health Systems Insurance Company [220]	$91 - $107	1514%
Health Alliance [224]	$91	1514%
Hope Trust [806]	$96	1597%
Med-Pay [480]	$107 - $124	1780%
Unicare [568]	$107 - $125	1780%
First Health Commercial [734]	$123	2047%
Beechstreet [551]	$124	2063%
Detego Health [868]	$124	2063%
Health Systems Inc [620]	$124	2063%
Healthcare Sol Mercy [609]	$124	2063%
Multiplan Commercial [737]	$124	2063%
Multiplan [240]	$124	2063%
Phcs [244]	$124 - $132	2063%
Preferred Health Professionals [561]	$125	2080%
Medica [661]	$132	2196%
Hfn [563]	$140	2329%

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 $99.
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 Barnes Jewish 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.