CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Ohiohealth Morrow County Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $22
  • Cash Discount Price: $38
  • vs. Medicare Baseline: 3.66x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Ohiohealth Morrow County Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 3.66x the Medicare baseline. Located in 651 West Marion Road, Mount Gilead, OH.
Cash / Self-Pay
$38

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $38 (632%)
Insurance Median: $22 (366%)
Cash: $38 (632% of Medicare)
Ins. Median: $22 (366% 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 366% of the Medicare baseline (a markup of 266%). 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
Blue Cross Blue Shield $3 - $21 50%
Amerihealth Caritas - All Plans $12 200%
Humana $12 - $54 200%
Medicaid / KanCare $12 200%
UnitedHealthcare $12 - $47 200%
Molina Exchange - All Other Plans $20 333%
Medicare (plans) $21 - $22 349%
Aetna $22 - $50 366%
Caresource Marketplace - All Other Plans $27 449%
Medical Mutual Of Ohio Marketplace $43 715%
Ohiohealthy Network - All Other Plans $43 715%
Ohiohealthy Preferred $43 715%
Medical Mutual Of Ohio Comm - All Other Plans $47 782%
Medical Mutual Of Ohio - Admin Serv $49 815%
Phcs - All Plans $53 882%
Cigna $54 899%
Healthstar Comm - All Plans $55 915%
Multiplan - All Plans $55 915%
Beech Street - All Plans $56 932%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 West Marion Road, Mount Gilead, OH 43338
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals