CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: North Carolina Baptist Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $30
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 4.99x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at North Carolina Baptist Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 4.99x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $44 (732%)
Insurance Median: $30 (499%)
Cash: $44 (732% of Medicare)
Ins. Median: $30 (499% 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 499% of the Medicare baseline (a markup of 399%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $6 - $77 100%
Apex $6 100%
Blue Cross Blue Shield $6 - $34 100%
Cigna $6 - $55 100%
Devoted $6 100%
Healthteam $6 100%
Humana $6 - $50 100%
Medicare (plans) $6 100%
UnitedHealthcare $6 - $31 100%
Wellcare $6 - $11 100%
Liberty $7 116%
Medcost $10 - $61 166%
Alliance $11 183%
Amerihealth $11 - $22 183%
Carolina Complete $11 183%
Health Blue $11 183%
Partners $11 183%
Trillium $11 183%
Vaya $11 183%
Ambetter / Centene $19 - $21 316%
Oscar $26 - $33 433%
Directnet $51 - $54 849%
Cone Health $60 - $64 998%
Healthgram $60 - $64 998%
First Carolina Care $69 - $73 1148%
Private Healthcare Systems $71 - $75 1181%
Multiplan $77 - $82 1281%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals