CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Fairfield Medical Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $17
  • Cash Discount Price: $12
  • vs. Medicare Baseline: 2.83x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Fairfield Medical Center is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 2.83x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.
Cash / Self-Pay
$12

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $12 (200%)
Insurance Median: $17 (283%)
Cash: $12 (200% of Medicare)
Ins. Median: $17 (283% 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 283% of the Medicare baseline (a markup of 183%). 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
Humana $5 - $27 83%
Aetna $6 - $18 100%
Allied Benefit Systems $6 - $19 100%
Blue Cross Blue Shield $6 - $26,250 100%
Buckeye Community Health $6 - $9 100%
Caresource $6 - $9 100%
Medical Mutual $6 - $33,500 100%
Medicare (plans) $6 100%
Medigold $6 100%
Meritain Health $6 - $19 100%
Molina $6 - $10 100%
Oscar $6 100%
The Health Plan $6 - $19 100%
UnitedHealthcare $6 - $16 100%
Va Ccn $6 100%
Valor Health Plan $6 100%
Bwc $8 133%
Amerihealth Caritas Ohio $9 150%
Medicaid / KanCare $9 150%
Quality Care Partners/Ohio Ppo Connect $19 - $20 316%
The Ohio State Health Plan $21 - $22 349%
Cigna $22 - $23 366%
Ohio Healthy $25 - $26 416%
Multiplan $26 - $27 433%
Miscellaneous Plans $27 - $28 449%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 401 North Ewing Street, Lancaster, OH 43130
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals