CMS Price Transparency Data
Blood test, clotting time (PTT)
Facility: Mercy Hospital Springfield
Billing Code: 85730 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85730
- Insurance Median: $12
- Cash Discount Price: $103
- vs. Medicare Baseline: 2.00x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Mercy Hospital Springfield is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 2.00x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$103
Average discount available for prompt cash payment at this facility.
Insurance Median
$12
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: $103 (1714%)
Insurance Median: $12 (200%)
Cash: $103 (1714% of Medicare)
Ins. Median: $12 (200% 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.
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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 |
|---|---|---|
| Aetna | $5 - $7 | 83% |
| Blue Cross Blue Shield | $5 - $121 | 83% |
| Humana | $5 - $107 | 83% |
| Medicaid / KanCare | $5 - $12 | 83% |
| Centurion Of Missouri [20459] | $6 | 100% |
| Champva [20065] | $6 | 100% |
| Cherokee Nation Health Serv Contracted [320066] | $6 | 100% |
| Cigna | $6 - $34 | 100% |
| Cross Timbers Hospice [20098] | $6 | 100% |
| Dept Of Veteran Affairs Contracted [320106] | $6 | 100% |
| Elara Caring Aspire Hospice [20433] | $6 | 100% |
| Globalhealth Contracted [320145] | $6 | 100% |
| Halo Hcr Inc Hospice Contracted [320432] | $6 | 100% |
| Halo Hcr Inc Hospice [20432] | $6 | 100% |
| Indian Health Service Contracted [320198] | $6 | 100% |
| Indian Health Service [20198] | $6 | 100% |
| Kindful Hospice Contracted [320434] | $6 | 100% |
| Kindful Hospice [20434] | $6 | 100% |
| Medica Contracted [320239] | $6 | 100% |
| Medica [20239] | $6 | 100% |
| Medicare (plans) | $6 | 100% |
| Mercy Hospice Okc [20252] | $6 | 100% |
| Mercy Mgd Behavioral Health Contracted [320259] | $6 | 100% |
| Mercy Rehab Hospital Contracted [320260] | $6 | 100% |
| Pace Of The Ozarks Contracted [320518] | $6 | 100% |
| Provider Partners Health Plans Contracted [320450] | $6 | 100% |
| Qual Choice Contracted [320325] | $6 | 100% |
| Tricare | $6 | 100% |
| United Medical Resources Contracted [320454] | $6 - $82 | 100% |
| UnitedHealthcare | $6 - $122 | 100% |
| Healthscope Contracted [320182] | $7 | 116% |
| Centivo Contracted [320505] | $10 | 166% |
| Providrs Care Network Contracted [320484] | $11 | 183% |
| Aither Health Contracted [320449] | $12 - $90 | 200% |
| Ambetter / Centene | $12 | 200% |
| Auxiant Contracted [320462] | $12 - $103 | 200% |
| Ebms Contracted [320493] | $12 | 200% |
| Healthlink Contracted [320179] | $12 - $36 | 200% |
| Home State Health Plan Contracted [320187] | $12 | 200% |
| Imagine 360 Contracted [320494] | $12 | 200% |
| Mercy Benefit Admin Contracted [320251] | $12 - $90 | 200% |
| Novasys Contracted [320285] | $12 | 200% |
| Reflect Health Contracted [320492] | $12 | 200% |
| Yuzu Health Contracted [320521] | $12 | 200% |
| 90 Degree Benefits Contracted [320436] | $35 | 582% |
| Show-Me Health Administrators Contracted [320483] | $35 - $37 | 582% |
| Benefit Management Contracted [320052] | $63 | 1048% |
| Health Systems Inc Contracted [320174] | $63 | 1048% |
| Insurance System Inc Contracted [320465] | $63 | 1048% |
| Administrative Payor Contracted [320005] | $71 - $79 | 1181% |
| Evolutions Health Care Contracted [320124] | $71 | 1181% |
| Point C Contracted [320238] | $71 - $118 | 1181% |
| Point C [20238] | $71 | 1181% |
| Medical Destinations Contracted [320242] | $79 | 1314% |
| Workers Comp [20426] | $79 - $134 | 1314% |
| First Health Contracted [320128] | $88 | 1464% |
| Edison Health Solutions Contracted [320502] | $90 | 1498% |
| Federal Medical Center Contracted [320127] | $95 | 1581% |
| Multiplan Contracted [320270] | $122 | 2030% |
| Private Health Care Systems Contracted [320320] | $122 | 2030% |
| Compcare Of The Ozarks Contracted [320437] | $125 | 2080% |
| American Healthcare Alliance Contracted [320020] | $126 | 2097% |
| Qual Choice Contracted [320324] | $126 | 2097% |
| Municipal Health Plan Contracted [320271] | $128 | 2130% |
| Usa Managed Care Org Contracted [320429] | $139 | 2313% |
| Ppo Plus Contracted [320310] | $142 | 2363% |