CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Jones Memorial Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $6
Cash Discount Price: $21
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Jones Memorial Hospital is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.00x the Medicare baseline. Located in 191 North Main Street, Wellsville, NY.

Cash / Self-Pay

$21

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $21 (349%)

Insurance Median: $6 (100%)

Cash: $21 (349% of Medicare)

Ins. Median: $6 (100% 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.

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
Univera Healthcare 1706	$4 - $6	67%
UnitedHealthcare	$4 - $6	67%
Medicare (plans)	$5 - $12	83%
UPMC Health Plan 5138	$5	83%
Medicaid / KanCare	$5 - $14	83%
Humana	$6	100%
Mvp 2900	$6	100%
Cigna	$6	100%
Blue Cross Blue Shield	$6 - $12	100%
Total Senior Care 1319	$6	100%
Aetna	$6 - $10	100%
Fidelis 5155	$6	100%
Molina Healthcare 1723	$7 - $14	116%
Empire Plan 5179	$12	200%
Independent Health 5156	$12	200%

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 $21.
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 Jones 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.