CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: High Point Regional Health System

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $46
Cash Discount Price: $59
vs. Medicare Baseline: 7.65x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at High Point Regional Health System is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 7.65x the Medicare baseline. Located in 601 N Elm St, High Point, NC.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

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: $59 (982%)

Insurance Median: $46 (765%)

Cash: $59 (982% of Medicare)

Ins. Median: $46 (765% 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 765% of the Medicare baseline (a markup of 665%). 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
Alliance	$11	183%
Amerihealth	$11 - $19	183%
Carolina Complete	$11	183%
Healthy Blue	$11	183%
Partners	$11	183%
Trillium	$11	183%
UnitedHealthcare	$11 - $78	183%
Vaya	$11	183%
Wellcare	$11	183%
Ambetter / Centene	$21	349%
Blue Cross Blue Shield	$22 - $36	366%
Medcost	$31 - $75	516%
Aetna	$35 - $76	582%
Oscar	$35 - $47	582%
Cigna	$64	1065%
Directnet	$69	1148%
Private Healthcare Systems	$96	1597%
Multiplan	$105	1747%
Humana	$109 - $111	1814%

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 $59.
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 High Point Regional Health System 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.