CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Duncan Regional Hospital, Inc

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $123
Cash Discount Price: $13
vs. Medicare Baseline: 20.47x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Duncan Regional Hospital, Inc is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 20.47x the Medicare baseline. Located in 1407 Whisenant Drive, Duncan, OK.

Cash / Self-Pay

$13

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $13 (216%)

Insurance Median: $123 (2047%)

Cash: $13 (216% of Medicare)

Ins. Median: $123 (2047% 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 2047% of the Medicare baseline (a markup of 1947%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medica	$4	67%
Humana	$6	100%
Healthcare Highways	$7 - $121	116%
UnitedHealthcare	$12 - $126	200%
Aetna	$14 - $158	233%
Coventry	$14 - $158	233%
Oklahoma Health Network (Ohn)	$14 - $149	233%
Blue Cross Blue Shield	$15	250%
Cigna	$15 - $167	250%
First Health	$15 - $167	250%
Osma Health	$15 - $167	250%
Friday Health Plan	$16	266%
Healthsmart	$16 - $175	266%
Preferred Community Choice	$16 - $171	266%

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 $13.
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 Duncan Regional Hospital, Inc 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.