CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Intermountain Health St Vincent Regional Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $28
Cash Discount Price: Unavailable
vs. Medicare Baseline: 4.66x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Intermountain Health St Vincent Regional Hospital is $28. 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 4.66x the Medicare baseline. Located in 1233 N 30Th St, Billings, MT.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$28

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: $28 (466%)

Ins. Median: $28 (466% 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 466% of the Medicare baseline (a markup of 366%). 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
Medicare (plans)	$6	100%
UnitedHealthcare	$6 - $35	100%
Ebms-Employee Benefit Mng	$10 - $33	166%
Sibanye Stillwater Health Partners	$11	183%
Coastal Administrative Services	$12	200%
Exchange Other	$14 - $25	233%
Mt Health Co-Op	$14 - $25	233%
Allegiance	$15 - $34	250%
Pacific Steel And Recycling	$15	250%
Pacificsource	$15 - $35	250%
Blue Cross Blue Shield	$16 - $48	266%
Cigna	$18 - $34	300%
First Choice Health	$18 - $34	300%
Other	$18 - $34	300%
Meritain Health	$20 - $29	333%
Aetna	$22 - $24	366%
Preferred One	$30 - $36	499%
Interwest	$31 - $34	516%
Geha	$32 - $35	532%
Private Hlthcare Sys	$32 - $35	532%

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 Intermountain Health St Vincent Regional 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.