CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Texas Orthopedic Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $7
  • Cash Discount Price: $793
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Texas Orthopedic Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $793. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.16x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$793

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $793 (13195%)
Insurance Median: $7 (116%)
Cash: $793 (13195% of Medicare)
Ins. Median: $7 (116% 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 - $35 83%
Amerigroup $5 - $6 83%
Community Health Choice Mcd $5 83%
Texas Childrens Health Plans $5 - $132 83%
Texas Health Network $5 83%
United $5 - $357 83%
American Health Plan $6 100%
Blue Cross Blue Shield $6 - $278 100%
Christus (Usfhp) $6 100%
Cigna $6 - $32 100%
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%
Shared Health $6 100%
Superior Health Plan $6 - $48 100%
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 $190 3161%
Evry Health $217 3611%
Imagine Health $278 4626%
Healthsmart Preferred Care $341 - $674 5674%
Averde Health $357 5940%
Fidelis Securecare Of Tx $357 5940%
Coventry National First Health $423 7038%
Physicians Cooperative Of Texas $436 7255%
Rockport Workers Comp $436 7255%
Independent Medical System $476 7920%
National Healthcare Solutions $476 7920%
Southwest Medical $476 7920%
Coastal Comp $516 8586%
Multiplan $595 - $674 9900%
International Health Insurance $635 10566%
Physicians, Inc $674 11215%
Affiliated Ppo $714 11880%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals