CMS Price Transparency Data
Blood test, clotting time (PTT)
Facility: Mount Carmel New Albany Surgical Hospital
Billing Code: 85730 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85730
- Insurance Median: $29
- Cash Discount Price: $41
- vs. Medicare Baseline: 4.83x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Mount Carmel New Albany Surgical Hospital is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 4.83x the Medicare baseline. Located in 7333 Smith's Mill Road, New Albany, OH.
Cash / Self-Pay
$41
Average discount available for prompt cash payment at this facility.
Insurance Median
$29
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: $41 (682%)
Insurance Median: $29 (483%)
Cash: $41 (682% of Medicare)
Ins. Median: $29 (483% 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 483% of the Medicare baseline (a markup of 383%). 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 |
|---|---|---|
| Medicare (plans) | $5 - $6 | 83% |
| Aetna | $6 - $63 | 100% |
| Blue Benefit Administrators Of Massachusetts | $6 | 100% |
| Blue Care Network | $6 | 100% |
| Blue Cross Blue Shield | $6 - $63 | 100% |
| Blue Distinction Transplant | $6 | 100% |
| Blue Shield - Ca | $6 | 100% |
| Blue Shield - Id (Regence) | $6 | 100% |
| Blue Shield - Ny Highmark Northeastern | $6 | 100% |
| Blue Shield - Ny Highmark Western | $6 | 100% |
| Blue Shield - Pa (Highmark) | $6 | 100% |
| Blue Shield - Wa (Regence) | $6 | 100% |
| Hospice Mount Carmel | $6 | 100% |
| Oscar | $6 | 100% |
| Rural Carrier Health Benefit Plan | $6 | 100% |
| The Health Plan | $6 - $41 | 100% |
| UnitedHealthcare | $6 - $69 | 100% |
| Medical Mutual | $11 - $50 | 183% |
| Enterprise Group Planning | $12 | 200% |
| Custom Design Benefits | $13 | 216% |
| Quality Care Partners | $14 | 233% |
| Western & Southern Financial Group | $16 | 266% |
| American Postal Workers Secondary | $24 | 399% |
| Cigna | $24 | 399% |
| Health Partners | $24 | 399% |
| Healthgram | $24 | 399% |
| Mvp | $24 | 399% |
| Priority Health | $24 | 399% |
| Geha | $28 - $69 | 466% |
| Gravie Admin Services | $28 | 466% |
| Healthez | $28 | 466% |
| Meritain | $28 | 466% |
| Webtpa | $28 | 466% |
| Access Health | $29 | 483% |
| Acclaim | $29 | 483% |
| Administrative Concepts | $29 | 483% |
| Allegeant | $29 | 483% |
| Allied Benefit Systems | $29 | 483% |
| American Family | $29 | 483% |
| American Healthcare Alliance | $29 | 483% |
| American National | $29 | 483% |
| American Republic | $29 | 483% |
| Amerihealth | $29 | 483% |
| Aultcare | $29 | 483% |
| Automated Benefit Services | $29 | 483% |
| Auxiant | $29 | 483% |
| Benefit Administrative Systems,Llc | $29 | 483% |
| Boon Chapman | $29 | 483% |
| Cam Administrative Services | $29 | 483% |
| Christian Brother Services | $29 | 483% |
| Christian Brothers Holy Cross | $29 | 483% |
| Claimchoice Adminstrators | $29 | 483% |
| Comprehensive Benefits | $29 | 483% |
| Continental Life Insurance | $29 | 483% |
| Coventry | $29 | 483% |
| Custom Benefit Administrators | $29 | 483% |
| Cypress Benefit Administrators | $29 | 483% |
| Employee Benefit Concepts | $29 | 483% |
| Employee Benefit Management | $29 | 483% |
| Forest County Potawatomi | $29 | 483% |
| Freedom Life Insurance Company | $29 | 483% |
| Group Administrators | $29 | 483% |
| Group Marketing Services | $29 | 483% |
| Group Pension Administrators | $29 | 483% |
| Guardian | $29 | 483% |
| Health America | $29 | 483% |
| Health Choices | $29 | 483% |
| Healthcare Management Admin | $29 | 483% |
| Insight | $29 | 483% |
| Intercare | $29 | 483% |
| Jfp Benefit Management | $29 | 483% |
| Jp Farley Corporation | $29 | 483% |
| Key Benefit Administrator | $29 | 483% |
| Liberty Union Life Assurance Co | $29 | 483% |
| Lucent Health | $29 | 483% |
| Luminare Health | $29 | 483% |
| Magnacare | $29 | 483% |
| Medcost | $29 | 483% |
| Mutual Health Services | $29 | 483% |
| Mutual Of Omaha | $29 | 483% |
| Ncas | $29 | 483% |
| Nippon Life Ins | $29 | 483% |
| Nova | $29 | 483% |
| Painters Union Insurance Fund | $29 | 483% |
| Physicians Mutual | $29 | 483% |
| Plumbers Local 98 Insurance Fund | $29 | 483% |
| Prairie States | $29 | 483% |
| Preferred One | $29 | 483% |
| Primary Physician Care | $29 | 483% |
| Professional Benefit Administrators | $29 | 483% |
| Secureone Preferred United Plans | $29 | 483% |
| Siho Insurance Services | $29 | 483% |
| Sisco Benefits | $29 | 483% |
| The Loomis Company | $29 | 483% |
| Trustmark Small Business Benefits | $29 | 483% |
| U Of M Health Plan | $29 | 483% |
| Unicare | $29 | 483% |
| Unified Group Services | $29 | 483% |
| Us Health And Life | $29 | 483% |
| Valenz | $29 | 483% |
| Varipro | $29 | 483% |
| Wps | $29 | 483% |
| Humana | $32 - $63 | 532% |
| First Health | $33 | 549% |
| Consociate | $38 | 632% |
| Health Ohio Network | $38 | 632% |
| Medben | $38 - $47 | 632% |
| Caresource | $46 | 765% |
| Healthlink Inc | $47 | 782% |
| Medical Benefits Mutual | $47 | 782% |
| Ohio Health Choice | $47 | 782% |
| Ohio Ppo Connect | $47 | 782% |
| Ameriben | $50 | 832% |
| Luminare Health (Detroit) | $50 | 832% |
| Medi Share | $50 | 832% |
| Multiplan | $50 | 832% |
| Ohiohealthy | $50 | 832% |
| Osu Not Independent Choice | $50 | 832% |
| Phcs | $50 | 832% |
| Philadelphia American Life Insurance | $50 | 832% |
| Twin Valley Psychiatric | $50 | 832% |
| Health Smart | $54 | 899% |
| Bccp | $63 | 1048% |
| Medicaid / KanCare | $63 | 1048% |
| Optima Health | $63 | 1048% |
| Crime Victim Assistance | $632 | 10516% |
| Ohio Safe Program | $632 | 10516% |