CMS Price Transparency Data
Blood test, clotting time (PTT)
Facility: Mercy Hospital Oklahoma City, Inc
Billing Code: 85730 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85730
- Insurance Median: $25
- Cash Discount Price: $56
- vs. Medicare Baseline: 4.16x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Mercy Hospital Oklahoma City, Inc is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 4.16x the Medicare baseline. Located in 4300 West Memorial Road, Oklahoma City, OK.
Cash / Self-Pay
$56
Average discount available for prompt cash payment at this facility.
Insurance Median
$25
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: $56 (932%)
Insurance Median: $25 (416%)
Cash: $56 (932% of Medicare)
Ins. Median: $25 (416% 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 416% of the Medicare baseline (a markup of 316%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $5 - $95 | 83% |
| Humana | $5 - $91 | 83% |
| Medicaid / KanCare | $5 - $9 | 83% |
| Amg Spec Hosp Edmond [20034] | $6 | 100% |
| Blue Cross Blue Shield | $6 | 100% |
| Champva [20065] | $6 | 100% |
| Cherokee Nation Health Serv Contracted [320066] | $6 | 100% |
| Cigna | $6 - $10 | 100% |
| Cross Timbers Hospice [20098] | $6 | 100% |
| Dept Of Veteran Affairs Contracted [320106] | $6 | 100% |
| Elara Caring Aspire Hospice Contracted [320433] | $6 | 100% |
| Elara Caring Aspire Hospice [20433] | $6 | 100% |
| Globalhealth Contracted [320145] | $6 | 100% |
| Halo Hcr Inc Hospice Contracted [320432] | $6 | 100% |
| Halo Hcr Inc Hospice [20432] | $6 | 100% |
| Indian Health Service Contracted [320198] | $6 | 100% |
| Kindful Hospice Contracted [320434] | $6 | 100% |
| Kindful Hospice [20434] | $6 | 100% |
| Longevity Health Plan [10477] | $6 | 100% |
| Medicare (plans) | $6 | 100% |
| Mercy Hospice Okc [20252] | $6 | 100% |
| Mercy Rehab Hospital Contracted [320260] | $6 | 100% |
| Provider Partners Health Plans Contracted [320450] | $6 | 100% |
| Qual Choice Contracted [320325] | $6 | 100% |
| Tricare | $6 | 100% |
| United Medical Resources Contracted [320454] | $6 - $86 | 100% |
| UnitedHealthcare | $6 | 100% |
| Medica Contracted [320239] | $7 | 116% |
| Ambetter / Centene | $8 | 133% |
| Health Choice Contracted [320166] | $8 | 133% |
| Home State Health Plan Contracted [320187] | $8 | 133% |
| Novasys Contracted [320285] | $8 | 133% |
| Community Care Contracted [320080] | $9 - $92 | 150% |
| Workers Comp [20426] | $10 | 166% |
| Healthsmart Preferred Care Contracted [320184] | $13 - $86 | 216% |
| Kempton Contracted [320214] | $13 | 216% |
| Healthcare Highways Plus Contracted [320175] | $16 - $79 | 266% |
| Webtpa Contracted [320417] | $17 - $55 | 283% |
| Osma Health Contracted [320292] | $18 - $59 | 300% |
| Aither Health Contracted [320449] | $25 - $79 | 416% |
| Auxiant Contracted [320462] | $25 - $86 | 416% |
| Benefit Management Contracted [320052] | $25 - $86 | 416% |
| Ebms Contracted [320493] | $25 - $79 | 416% |
| First Health Contracted [320128] | $25 - $81 | 416% |
| Healthlink Contracted [320179] | $25 - $86 | 416% |
| Imagine 360 Contracted [320494] | $25 - $79 | 416% |
| Mercy Benefit Admin Contracted [320251] | $25 - $86 | 416% |
| Quik Trip Contracted [320447] | $25 - $79 | 416% |
| Reflect Health Contracted [320492] | $25 - $79 | 416% |
| Show-Me Health Administrators Contracted [320483] | $25 - $79 | 416% |
| Yuzu Health Contracted [320521] | $25 - $79 | 416% |
| Federal Medical Center Contracted [320127] | $27 - $86 | 449% |
| Healthscope Contracted [320182] | $27 - $86 | 449% |
| Healthsmart Accel Contracted [320183] | $27 - $86 | 449% |
| Point C Contracted [320238] | $27 - $86 | 449% |
| Preferred Health Plan Contracted [320522] | $27 - $86 | 449% |
| Private Health Care Systems Contracted [320320] | $27 - $92 | 449% |
| Tri State Healthcare Coalition Contracted [320379] | $27 - $86 | 449% |
| Globalhealth Contracted [320144] | $29 - $94 | 483% |
| Multiplan Contracted [320270] | $29 - $119 | 483% |
| Preferred Community Choice Contracted [320311] | $31 - $100 | 516% |
| Centralink Contracted [320480] | $41 - $132 | 682% |