CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Lancaster Rehabilitation Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $36
Cash Discount Price: $54
vs. Medicare Baseline: 5.99x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Lancaster Rehabilitation Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 5.99x the Medicare baseline. Located in 675 Good Dr, Lancaster, PA.

Cash / Self-Pay

$54

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $54 (899%)

Insurance Median: $36 (599%)

Cash: $54 (899% of Medicare)

Ins. Median: $36 (599% 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 599% of the Medicare baseline (a markup of 499%). 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
Multiplan	$11 - $53	183%
Fed Med	$12 - $58	200%
Aetna	$19 - $89	316%
All Well - PA Health & Wellness	$19 - $89	316%
Ambetter / Centene	$19 - $89	316%
Amerihealth Caritas	$19 - $89	316%
Blue Cross Blue Shield	$19 - $89	316%
Cigna	$19 - $89	316%
Freedom Blue Cpd (Highmark Freedcom Blue)	$19 - $89	316%
Geha	$19 - $89	316%
Geisinger	$19 - $89	316%
Geisinger Gold	$19 - $89	316%
Geisinger Health Cpd	$19 - $89	316%
Highmark	$19 - $89	316%
Highmark (Freedom Blue)	$19 - $89	316%
Highmark Wholecare McD (Formerly Gateway)	$19 - $89	316%
Highmark Wholecare Mgg (Formerly Gateway)	$19 - $89	316%
Humana	$19 - $89	316%
Medishare	$19 - $89	316%
Optimum Healthcare	$19 - $89	316%
Out of Area Blues	$19 - $89	316%
PA Medical Assistance	$19 - $89	316%
Preferred Health Care (Eliance)	$19 - $89	316%
Tricare	$19 - $89	316%
Triwest	$19 - $89	316%
UPMC Health Plan	$19 - $89	316%
UPMC for Life	$19 - $89	316%
UPMC for You	$19 - $89	316%
UnitedHealthcare	$19 - $89	316%

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 $54.
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 Lancaster Rehabilitation Hospital 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.