CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Mercy Hospital Lincoln

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $57
Cash Discount Price: $79
vs. Medicare Baseline: 9.48x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Mercy Hospital Lincoln is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 9.48x the Medicare baseline. Located in 1000 East Cherry Street, Troy, MO.

Cash / Self-Pay

$79

Average discount available for prompt cash payment at this facility.

Insurance Median

$57

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: $79 (1314%)

Insurance Median: $57 (948%)

Cash: $79 (1314% of Medicare)

Ins. Median: $57 (948% 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 948% of the Medicare baseline (a markup of 848%). 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
United Medical Resources Contracted [320454]	$6	100%
UnitedHealthcare	$6 - $28	100%
Blue Cross Blue Shield	$7 - $57	116%
Cigna	$8 - $30	133%
Healthlink Contracted [320179]	$8 - $103	133%
Medicaid / KanCare	$8 - $56	133%
Aetna	$18 - $79	300%
Medicare (plans)	$26 - $121	433%
Tricare	$26	433%
American Health Advantage Of Mo Mcr [10473]	$28	466%
Cherokee Nation Health Serv Contracted [320066]	$28	466%
Cross Timbers Hospice [20098]	$28	466%
Dept Of Veteran Affairs Contracted [320106]	$28	466%
Elara Caring Aspire Hospice Contracted [320433]	$28	466%
Elara Caring Aspire Hospice [20433]	$28	466%
Globalhealth Contracted [320145]	$28	466%
Halo Hcr Inc Hospice Contracted [320432]	$28	466%
Halo Hcr Inc Hospice [20432]	$28	466%
Humana	$28 - $109	466%
Indian Health Service Contracted [320198]	$28	466%
Kindful Hospice Contracted [320434]	$28	466%
Kindful Hospice [20434]	$28	466%
Mercy Hospice Okc [20252]	$28	466%
Pace Of The Ozarks Contracted [320518]	$28	466%
Provider Partners Health Plans Contracted [320450]	$28	466%
Qual Choice Contracted [320325]	$28	466%
Centivo Contracted [320505]	$44	732%
Medica Contracted [320239]	$51	849%
Ambetter / Centene	$56	932%
Home State Health Plan Contracted [320187]	$56	932%
Novasys Contracted [320285]	$56	932%
Hope Trust Contracted [320488]	$60	998%
Health Choices Contracted [320448]	$73	1215%
Health Choices [20448]	$73	1215%
Medical Associates Health Contracted [320444]	$73	1215%
First Health Contracted [320128]	$79 - $91	1314%
Mercy Mgd Behavioral Health Contracted [320259]	$91	1514%
Multiplan Contracted [320270]	$91	1514%
Private Health Care Systems Contracted [320320]	$91	1514%
Workers Comp [20426]	$91 - $97	1514%
Aither Health Contracted [320449]	$103	1714%
Aither Health [20449]	$103	1714%
Auxiant Contracted [320462]	$103	1714%
Ebms Contracted [320493]	$103	1714%
Edison Health Solutions Contracted [320502]	$103	1714%
Federal Medical Center Contracted [320127]	$103	1714%
Imagine 360 Contracted [320494]	$103	1714%
Insurance System Inc Contracted [320465]	$103	1714%
Mercy Benefit Admin Contracted [320251]	$103	1714%
Mercy Benefit Admin [20251]	$103	1714%
Point C Contracted [320238]	$103	1714%
Preferred Health Plan Contracted [320522]	$103	1714%
Reflect Health Contracted [320492]	$103	1714%
Show-Me Health Administrators Contracted [320483]	$103	1714%
Tri State Healthcare Coalition Contracted [320379]	$103	1714%
Yuzu Health Contracted [320521]	$103	1714%

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 $79.
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 Lincoln 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.