CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Shannon Medical Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $161
Cash Discount Price: $124
vs. Medicare Baseline: 26.79x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Shannon Medical Center is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $124. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 26.79x the Medicare baseline. Located in 120 E Harris Ave., San Angelo, TX.

Cash / Self-Pay

$124

Average discount available for prompt cash payment at this facility.

Insurance Median

$161

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: $124 (2063%)

Insurance Median: $161 (2679%)

Cash: $124 (2063% of Medicare)

Ins. Median: $161 (2679% 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 2679% of the Medicare baseline (a markup of 2579%). 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
Care Improvement	$6	100%
Humana	$6 - $202	100%
Molina Healthcare - Chip	$6	100%
Wellmed	$6	100%
Wellpoint	$7 - $8	116%
Scott & White	$9	150%
Cigna	$10	166%
Insurance Management Services	$10	166%
Insurance Services Of Lubbock	$10	166%
Kempton Group	$12	200%
Pdh/Texas Trust	$12	200%
Ambetter / Centene	$13	216%
90 Degree Benefits	$15	250%
Caprock	$15	250%
Blue Cross Blue Shield	$19 - $189	316%
City Of San Angelo	$34 - $35	566%
Web Tpa	$110 - $113	1830%
Aetna	$161 - $166	2679%
Assurant Health	$161 - $166	2679%
First Health	$183 - $189	3045%
UnitedHealthcare	$190 - $197	3161%
Healthsmart	$217 - $224	3611%

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 $124.
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 Shannon Medical Center 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.