CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Essentia Health

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $50
  • Cash Discount Price: $71
  • vs. Medicare Baseline: 8.32x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Essentia Health is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 8.32x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.
Cash / Self-Pay
$71

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

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: $71 (1181%)
Insurance Median: $50 (832%)
Cash: $71 (1181% of Medicare)
Ins. Median: $50 (832% 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 832% of the Medicare baseline (a markup of 732%). 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
Advocare/Security Health $6 100%
Blue Cross Blue Shield $6 - $70 100%
Freedom Blue Ppo $6 100%
Healthpartners Care Msho / Mcr Adv $6 100%
Imcare Msho Pcc Prime $6 100%
Imcare Msho Ref Req $6 100%
Itasca Med Care $6 100%
Medica Advantage Solutions $6 100%
Medica Msho/Dual Solutions $6 100%
Medica Prime Solution Group $6 100%
Medicare (plans) $6 100%
Nd Va Administration $6 100%
Platinum Blue/Vantage Blue $6 100%
Primewest $6 100%
Primewest Msho $6 100%
Secure Blue Msho $6 100%
Ubh Cost Plan $6 100%
Ubh Msho $6 100%
Ucare Msho $6 100%
UnitedHealthcare $6 - $82 100%
Sanford Health Plan $19 - $46 316%
Medica Access $23 - $28 383%
Healthpartners Care Pmap $33 - $40 549%
Medica $47 - $63 782%
Medica Uplan $47 - $57 782%
Medica Choice $54 - $65 899%
Ucare $56 - $68 932%
Cigna $57 - $69 948%
Healthpartners $57 - $69 948%
Healthpartners Pcc Prime $57 - $69 948%
Wea $61 - $79 1015%
America'S Ppo $66 - $80 1098%
Wps $71 - $87 1181%
Aetna $72 - $88 1198%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 32Nd Ave South, Fargo, ND 58104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals