CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Caromont Regional Medical Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $10
Cash Discount Price: $72
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Caromont Regional Medical Center is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.66x the Medicare baseline. Located in 2525 Court Dr, Gastonia, NC.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$10

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: $72 (1198%)

Insurance Median: $10 (166%)

Cash: $72 (1198% of Medicare)

Ins. Median: $10 (166% 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.

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
Avalon	$4	67%
Humana	$4 - $106	67%
UnitedHealthcare	$4 - $26	67%
Aetna	$6 - $45	100%
Blue Cross Blue Shield	$6 - $40	100%
Devoted Health	$6	100%
Healthteam	$6	100%
Longevity Health	$6	100%
Molina	$6 - $7	100%
Absolute Total Care	$7	116%
Corporate Benefits Service	$7	116%
Medcost	$8 - $46	133%
Alliance Behavioral Health	$10	166%
Amerihealth Caritas	$10	166%
Carolina Complete Health	$10	166%
Carolina Complete Health Tailored Plans	$10	166%
Partners Behavioral Health	$10	166%
Vaya Behavioral Health	$10	166%
Wellcare	$10	166%
Cigna	$11 - $18	183%
Surgery Plus	$11	183%
Carolina Caring	$15 - $96	250%
Beech Street	$18 - $99	300%
Multiplan	$18 - $99	300%
Gaston County Jail	$20	333%
Self Pay	$20 - $109	333%
First Health Network	$21 - $115	349%

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 $72.
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 Caromont Regional Medical Center 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.