CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $7
  • Cash Discount Price: $17
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Montefiore Mount Vernon Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.16x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
$17

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $17 (283%)
Insurance Median: $7 (116%)
Cash: $17 (283% of Medicare)
Ins. Median: $7 (116% 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.

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
Wellcare $5 - $6 83%
Amidacare $6 - $7 100%
Blue Cross Blue Shield $6 - $21 100%
Centerlight $6 - $7 100%
Emblem $6 - $21 100%
Fidelis $6 - $11 100%
Healthfirst $6 - $10 100%
Medicaid / KanCare $6 100%
Point Comfort $6 100%
UnitedHealthcare $6 - $12 100%
Villagecaremax $6 100%
Vnsny Choice $6 - $7 100%
Humana $7 116%
Longevity $7 116%
Vnsny Select Health $7 116%
Metroplus $8 133%
Oscar $8 133%
American Postal Workers $12 200%
Mvp $12 200%
Centivo $16 266%
Elderplan $21 349%
Aetna $27 - $30 449%
Cigna $58 - $65 965%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals