CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Lancaster General Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $12
  • Cash Discount Price: $43
  • vs. Medicare Baseline: 2.00x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Lancaster General Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 2.00x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$43

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $43 (715%)
Insurance Median: $12 (200%)
Cash: $43 (715% of Medicare)
Ins. Median: $12 (200% 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.

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
Highmark $2 - $44 33%
Hospice And Community Care $2 - $8 33%
Highmark Commercial Preferred $3 - $44 50%
Lancashire Hall $3 - $44 50%
Lg Coresource/Lg Eliance $3 - $13 50%
Nursing Home Op Services $3 - $13 50%
Old Order Group $3 - $14 50%
Affilia Home Health $4 - $44 67%
Eliance Health Solutions $4 - $28 67%
Masonic Homes $4 - $44 67%
Highmark Commercial Non-Preferred $5 - $44 83%
Tricare $5 83%
Aetna $6 - $26 100%
Albright Life $6 100%
Amerihealth Caritas $6 - $8 100%
Blue Cross Blue Shield $6 - $37 100%
Cigna $6 - $37 100%
Coatesville Va $6 100%
Devoted Health $6 100%
Health Partners Mcr Advantage $6 100%
Hospice Generic $6 100%
Lebanon Veterans Hospital $6 100%
Medicare (plans) $6 - $7 100%
Pa Health And Wellness Mcr $6 100%
Preferred Healthcare $6 - $37 100%
UnitedHealthcare $6 - $37 100%
Devon $8 - $37 133%
Ehp $8 - $36 133%
Geisinger Commercial $8 - $37 133%
Intergroup Services $8 - $37 133%
Lancaster County Mh $8 133%
Medicaid / KanCare $8 - $12 133%
Upmc Commercial $8 - $37 133%
Elap Employees $9 150%
Gateway $9 150%
Commercial Generic $10 - $44 166%
Magellan $10 - $44 166%
Medi-Share Christian Care $10 - $42 166%
United Behavioral Health $10 - $44 166%
Upmc For You $10 - $13 166%
Value Options $10 - $44 166%
Workers Compensation $10 - $44 166%
Oscar Health Plan $12 200%
Claim Watcher Plus $18 300%
Claim Watcher $20 333%
Elap Other Groups $22 366%
Gift Of Life Donor Program $13,500 224626%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals