Blood test, clotting time (PTT)
Facility: Hackensack Meridian Health Pascack Valley Medical
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $130
- Cash Discount Price: $7
- vs. Medicare Baseline: 21.63x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 2163% of the Medicare baseline (a markup of 2063%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Healthscope Benefits [2290] | $12 - $130 | 200% |
| UnitedHealthcare | $12 - $143 | 200% |
| Medicare (plans) | $28 | 466% |
| Aetna | $34 | 566% |
| Create Flex / Select [3580] | $63 | 1048% |
| Web Tpa [2115] | $63 | 1048% |
| Commercial Generic [1285] | $63 | 1048% |
| Lucent Health [6000] | $63 | 1048% |
| Black Lung [6055] | $63 | 1048% |
| Selecthealth [3740] | $63 | 1048% |
| Oncology Patient Assistance Programs [2295] | $63 | 1048% |
| Wtc Healthcare Sme Karna [8005] | $63 | 1048% |
| Worker's Comp [2125] | $63 - $122 | 1048% |
| Healthcare Highways [2210] | $63 - $130 | 1048% |
| Horizon [3625] | $63 - $143 | 1048% |
| Magnacare Commercial [3650] | $122 | 2030% |
| Qualcare [3725] | $128 - $148 | 2130% |
| Pba [1775] | $130 | 2163% |
| Gilsbar [1425] | $130 | 2163% |
| Healthcost Solutions [2415] | $130 | 2163% |
| Trustmark [2030] | $130 | 2163% |
| Healthnet [1495] | $130 | 2163% |
| Mutual of Omaha [1685] | $130 | 2163% |
| Mayo Clinic Health Solutions [2280] | $130 | 2163% |
| First Health [1375] | $130 | 2163% |
| Multiplan [1680] | $130 | 2163% |
| Resource One Administrators [2815] | $130 | 2163% |
| PHCS [1780] | $130 | 2163% |
| Hometown Health [2155] | $130 | 2163% |
| Pan American Life Insurance Co [1770] | $130 | 2163% |
| Healthfirst [2395] | $130 | 2163% |
| Planned Administrators Inc [2360] | $130 | 2163% |
| New Era Life Insurance Company [1705] | $130 | 2163% |
| Allied National Global Care [1035] | $130 | 2163% |
| Administrative Concepts [1005] | $130 | 2163% |
| Universal Fidelity [2085] | $130 | 2163% |
| Blue Cross Blue Shield | $143 | 2379% |
| Emblem Health [2430] | $148 | 2463% |
| Humana | $148 | 2463% |
| Amerihealth [3520] | $153 | 2546% |