CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: HCA Houston Healthcare West

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $13
  • Cash Discount Price: $433
  • vs. Medicare Baseline: 2.16x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at HCA Houston Healthcare West is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $433. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 2.16x the Medicare baseline. Located in 12141 Richmond Ave, Houston, TX.
Cash / Self-Pay
$433

Average discount available for prompt cash payment at this facility.

Insurance Median
$13

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: $433 (7205%)
Insurance Median: $13 (216%)
Cash: $433 (7205% of Medicare)
Ins. Median: $13 (216% 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 216% of the Medicare baseline (a markup of 116%). 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
Aetna $5 - $40 83%
Amerigroup $5 - $6 83%
Community Health Choice Mcd $5 83%
Texas Childrens Health Plans $5 - $120 83%
Texas Health Network $5 83%
United $5 - $324 83%
American Health Plan $6 100%
Blue Cross Blue Shield $6 - $252 100%
Chc Harris Health $6 100%
Christus (Usfhp) $6 100%
Cigna $6 - $577 100%
Devoted Health $6 100%
Humana $6 - $80 100%
Integranet Amerigroup Ipa $6 100%
Kelsey Seybold $6 100%
Molina Healthcare $6 - $13 100%
Oscar $6 - $17 100%
Procare Advantage $6 100%
Provider Partners Health Plan Of Texas $6 100%
Renaissance Ipa Radiology $6 100%
Shared Health $6 100%
Superior Health Plan $6 - $43 100%
Triwest Health Alliance $6 100%
Triwest Healthcare Alliance $6 100%
Van Lang Ipa $6 100%
Wellcare $6 100%
Wellmed $6 100%
Molina $7 116%
Universal Healthcare Group $7 116%
Verda Health Plan $8 133%
Community Health Choice $9 150%
Superior $9 150%
Corvel Corporation $12 200%
Omni Healthcare $13 216%
Healthcare Highways $18 300%
Texas Workforce Commission $35 - $173 582%
Evry Health $40 - $197 666%
Imagine Health $51 - $252 849%
Healthsmart Preferred Care $62 - $613 1032%
Averde Health $65 - $324 1082%
Fidelis Securecare Of Tx $65 - $324 1082%
Coventry National First Health $77 - $384 1281%
Physicians Cooperative Of Texas $80 - $397 1331%
Rockport Workers Comp $80 - $397 1331%
Independent Medical System $87 - $433 1448%
National Healthcare Solutions $87 - $433 1448%
Southwest Medical $87 - $433 1448%
Triumph $87 - $433 1448%
Coastal Comp $94 - $469 1564%
Multiplan $109 - $613 1814%
Physicians, Inc $123 - $613 2047%
Affiliated Ppo $130 - $649 2163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12141 Richmond Ave, Houston, TX 77082
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals