CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: UT Health East Texas Tyler Regional Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $64
Cash Discount Price: $25
vs. Medicare Baseline: 10.65x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at UT Health East Texas Tyler Regional Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 10.65x the Medicare baseline. Located in 1000 South Beckham Ave, Tyler, TX.

Cash / Self-Pay

$25

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $25 (416%)

Insurance Median: $64 (1065%)

Cash: $25 (416% of Medicare)

Ins. Median: $64 (1065% 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 1065% of the Medicare baseline (a markup of 965%). 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
Amerigroup Commercial [5055]	$64	1065%
Black Lung [6055]	$64	1065%
Cigna	$64	1065%
Healthcare Highways [2210]	$64	1065%
Healthscope Benefits [2290]	$64	1065%
Lucent Health [6000]	$64	1065%
Medicaid / KanCare	$64	1065%
Parkland Community Health Plan [6015]	$64	1065%
UnitedHealthcare	$64	1065%
Web Tpa [2115]	$64	1065%
Group Pension Admin [1450]	$168	2795%
Phcs [1780]	$168	2795%

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 $25.
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 UT Health East Texas Tyler Regional 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.