CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $48
  • Cash Discount Price: $219
  • vs. Medicare Baseline: 7.99x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Hospital of Univ of Pennsylvania is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $219. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 7.99x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$219

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $219 (3644%)
Insurance Median: $48 (799%)
Cash: $219 (3644% of Medicare)
Ins. Median: $48 (799% 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 799% of the Medicare baseline (a markup of 699%). 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
Gspp And Wissahickon Hospice $3 50%
Cigna $4 - $99 67%
UnitedHealthcare $5 - $219 83%
Aetna $6 - $219 100%
Blue Cross Blue Shield $6 - $161 100%
Clover Health Plan $6 100%
Devoted Health $6 100%
Geisinger Health Plan $6 - $19 100%
Health Partners $6 - $219 100%
Humana $6 - $175 100%
Ibc $6 100%
Kaiser Permanente $6 - $219 100%
Medicare (plans) $6 100%
Pa Health And Wellness $6 - $10 100%
Penn Life (Living Independently For Elders) $6 100%
Philadelphia Va Medical Center $6 100%
Upmc $6 - $219 100%
Gateway Health Plan $7 116%
Keystone First $7 116%
Tricare $7 116%
Us Family Health Plan $7 116%
Medicaid / KanCare $8 - $219 133%
Pa Medical Assistance $8 - $219 133%
Elap $9 150%
Claims Watcher $10 - $11 166%
Keystone Mercy Health Plan $10 - $219 166%
Oscar Health Plan $10 166%
Centivo $11 183%
Elap Services $11 183%
Ibc Commercial Hpn $11 183%
Keystone Hmo Proactive $11 183%
Highmark $13 216%
Penn Global Medicine $16 266%
Paired Kidney Exchange $18 300%
Horizon Nj Health $37 - $38 616%
Preferred Health Care Eliance $48 799%
Pgm - Regie De L'Assurance Maladie Quebec $50 832%
Pgm - Kuwait Defense $77 - $99 1281%
Qualcare $83 1381%
Olympus $86 1431%
Coventry $88 - $112 1464%
Pgm - Chop $88 1464%
Wissahickon Hospice $88 1464%
Healthamerica/Coventry $99 - $107 1647%
First Health Global $110 1830%
Health Net $131 2180%
Pgm - Royal Embassy Of Saudi Arabia $131 2180%
Pgm - Embassy Of Qatar $142 2363%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $142 2363%
Interlink $147 2446%
Pgm - Embassy Of The United Emirates/Ipc $153 2546%
Health America/Ccn $175 2912%
Intergroup $175 2912%
Pgm - Kuwait Health Division $175 2912%
Pgm - Kuwait Oil $175 2912%
Preferred Care $175 2912%
Blue Quality Centers For Transplant (Bqct) $219 3644%
City Of Philadelphia Behavioral Health $219 3644%
Commercial Other $219 3644%
International Pfs $219 3644%
United Behavioral Health $219 3644%
Workers Compensation $219 3644%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals