CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Frisbie Memorial Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $43
Cash Discount Price: $226
vs. Medicare Baseline: 7.15x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Frisbie Memorial Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $226. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 7.15x the Medicare baseline. Located in 11 Whitehall Road, Rochester, NH.

Cash / Self-Pay

$226

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $226 (3760%)

Insurance Median: $43 (715%)

Cash: $226 (3760% of Medicare)

Ins. Median: $43 (715% 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 715% of the Medicare baseline (a markup of 615%). 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
Amerihealth Caritas	$5	83%
Well Sense Health Plan	$5	83%
Aetna	$6 - $131	100%
Humana	$6	100%
Cigna	$6 - $132	100%
Martin's Point Health	$6	100%
United	$6 - $136	100%
Blue Cross Blue Shield	$6 - $90	100%
Evernorth Behavioral Health	$6	100%
United VA Ccn	$6	100%
Ambetter / Centene	$11	183%
Harvard Pilgrim	$60 - $92	998%
Maine Community Health	$64 - $109	1065%
Tufts Health Plan	$78 - $129	1298%
Evernorth	$181	3012%

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 $226.
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 Frisbie Memorial Hospital 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.