CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Rio Grande Regional Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $8
  • Cash Discount Price: $768
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Rio Grande Regional Hospital is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $768. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.33x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
$768

Average discount available for prompt cash payment at this facility.

Insurance Median
$8

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: $768 (12779%)
Insurance Median: $8 (133%)
Cash: $768 (12779% of Medicare)
Ins. Median: $8 (133% 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.

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 - $6 83%
Driscoll Children'S Health Plan $5 83%
Texas Health Network $5 83%
United $5 - $346 83%
Allegian Health $6 - $307 100%
American Health Plan $6 100%
Blue Cross Blue Shield $6 - $346 100%
Cigna $6 - $22 100%
Humana $6 - $21 100%
Independent Medical System $6 100%
Molina Healthcare $6 - $15 100%
Physicians Health Choice $6 100%
Prominence Health $6 100%
Provider Partners Health Plan Of Texas $6 100%
Shared Health $6 100%
Superior Health Plan $6 - $54 100%
Triwest Health Alliance $6 100%
Triwest Healthcare Alliance $6 100%
Wellmed $6 100%
Molina $7 116%
Universal Health Care $7 116%
Superior $9 150%
Corvel Corporation $12 200%
Focus Healthcare $12 200%
Omni Healthcare $13 216%
Oscar $14 233%
Healthcare Highways $18 300%
Texas Workforce Commission $184 3062%
Averde Health $253 4210%
Healthsmart Preferred Care $330 - $653 5491%
First Health $442 7354%
National Healthcare Solutions $461 7671%
Southwest Medical $461 7671%
Coastal Comp $499 8303%
Usa Managed Care $499 - $614 8303%
Ppo Next/ Medical Control $576 9584%
Beech Street $614 10216%
Multiplan $614 10216%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 E Ridge Rd, McAllen, TX 78503
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals