CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: St James Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $89
Cash Discount Price: Unavailable
vs. Medicare Baseline: 14.81x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at St James Hospital is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 14.81x the Medicare baseline. Located in 400 S Clark St, Butte, MT.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$89

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%)

Insurance Median: $89 (1481%)

Ins. Median: $89 (1481% 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 1481% of the Medicare baseline (a markup of 1381%). 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
Humana	$6	100%
UnitedHealthcare	$6 - $84	100%
Coastal Administrative Services	$13	216%
Allegiance	$15 - $94	250%
First Choice Health	$29 - $89	483%
Ebms-Employee Benefit Mng	$33 - $89	549%
Pacificsource	$40 - $94	666%
Blue Cross Blue Shield	$48 - $99	799%
Cigna	$51 - $94	849%
Geha	$83 - $84	1381%
Mt Health Co-Op	$89 - $90	1481%
Aetna	$92 - $94	1531%
Interwest	$92 - $94	1531%
Meritain Health	$92 - $94	1531%

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 $X.
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 St James 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.