CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Carolina East Medical Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $60
Cash Discount Price: $48
vs. Medicare Baseline: 9.98x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Carolina East Medical Center is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 9.98x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$48

Average discount available for prompt cash payment at this facility.

Insurance Median

$60

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: $48 (799%)

Insurance Median: $60 (998%)

Cash: $48 (799% of Medicare)

Ins. Median: $60 (998% 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 998% of the Medicare baseline (a markup of 898%). 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%
Inclusive Health (Nchirp)-All Plans	$6	100%
Tricare	$6 - $84	100%
Craven Co. Jail Systems - All Plans	$15 - $28	250%
Pamlico Co Jail-All Plans	$19 - $22	316%
UnitedHealthcare	$28 - $60	466%
Medcost Ppo Ultra (Employees)	$44 - $53	732%
Medcost Ppo Employees And Retirees	$47 - $55	782%
Blue Cross Blue Shield	$49 - $58	815%
Medcost Ppo City Employees	$52 - $61	865%
Medcost Ppo County Employee	$54 - $64	899%
Benefit Mgmt, Svcs-All Plans	$60 - $71	998%
Aetna	$63 - $74	1048%
Medcost Benefit Svc-All Other Plans	$63 - $74	1048%
Acs Consult Svc Inc-All Plans	$64 - $76	1065%
Medcost Ppo Standard	$64 - $76	1065%
Cigna	$65 - $76	1082%

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 $48.
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 Carolina East 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.