CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Mercy Hospital - Cassville

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $90
Cash Discount Price: $73
vs. Medicare Baseline: 14.98x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Mercy Hospital - Cassville is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 14.98x the Medicare baseline. Located in 94 Main Street, Cassville, MO.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$90

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: $73 (1215%)

Insurance Median: $90 (1498%)

Cash: $73 (1215% of Medicare)

Ins. Median: $90 (1498% 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 1498% of the Medicare baseline (a markup of 1398%). 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
Aetna	$5 - $101	83%
Humana	$5 - $96	83%
Medicaid / KanCare	$5 - $59	83%
Blue Cross Blue Shield	$6 - $110	100%
Medicare (plans)	$6 - $48	100%
UnitedHealthcare	$8 - $107	133%
Dept Of Veteran Affairs Contracted [320106]	$39	649%
Tricare	$46	765%
Cherokee Nation Health Serv Contracted [320066]	$47	782%
Cigna	$47 - $107	782%
Cross Timbers Hospice [20098]	$47	782%
Elara Caring Aspire Hospice [20433]	$47	782%
Globalhealth Contracted [320145]	$47	782%
Halo Hcr Inc Hospice Contracted [320432]	$47	782%
Halo Hcr Inc Hospice [20432]	$47	782%
Healthscope Contracted [320182]	$47	782%
Indian Health Service Contracted [320198]	$47	782%
Kindful Hospice Contracted [320434]	$47	782%
Kindful Hospice [20434]	$47	782%
Medical Associates Health Contracted [320444]	$47	782%
Mercy Hospice Okc [20252]	$47	782%
Mercy Mgd Behavioral Health Contracted [320259]	$47	782%
Pace Of The Ozarks Contracted [320518]	$47	782%
Provider Partners Health Plans Contracted [320450]	$47	782%
Qual Choice Contracted [320325]	$47	782%
Administrative Payor Contracted [320005]	$51	849%
Centivo Contracted [320505]	$58	965%
Ambetter / Centene	$59	982%
Home State Health Plan Contracted [320187]	$59	982%
Novasys Contracted [320285]	$59	982%
Healthlink Contracted [320179]	$73 - $102	1215%
Preferred Health Plan Contracted [320522]	$73	1215%
Health Systems Inc Contracted [320174]	$90	1498%
Insurance System Inc Contracted [320465]	$90	1498%
Point C Contracted [320238]	$90 - $102	1498%
Point C [20238]	$90	1498%
United Medical Resources Contracted [320454]	$90 - $96	1498%
Workers Comp [20426]	$90 - $102	1498%
Municipal Health Plan Contracted [320271]	$92	1531%
Medica Contracted [320239]	$101	1681%
90 Degree Benefits Contracted [320436]	$102	1697%
Aither Health Contracted [320449]	$102	1697%
American Healthcare Alliance Contracted [320020]	$102	1697%
Auxiant Contracted [320462]	$102	1697%
Benefit Management Contracted [320052]	$102	1697%
Ebms Contracted [320493]	$102	1697%
Edison Health Solutions Contracted [320502]	$102	1697%
Evolutions Health Care Contracted [320124]	$102	1697%
Imagine 360 Contracted [320494]	$102	1697%
Mercy Benefit Admin Contracted [320251]	$102	1697%
Reflect Health Contracted [320492]	$102	1697%
Show-Me Health Administrators Contracted [320483]	$102	1697%
Usa Managed Care Org Contracted [320429]	$102	1697%
Yuzu Health Contracted [320521]	$102	1697%
First Health Contracted [320128]	$107	1780%
Multiplan Contracted [320270]	$107	1780%
Private Health Care Systems Contracted [320320]	$107	1780%

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 $73.
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 Mercy Hospital - Cassville 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.