CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Sweeny Community Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $71
Cash Discount Price: $73
vs. Medicare Baseline: 11.81x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Sweeny Community Hospital is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 11.81x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $73 (1215%)

Insurance Median: $71 (1181%)

Cash: $73 (1215% of Medicare)

Ins. Median: $71 (1181% 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 1181% of the Medicare baseline (a markup of 1081%). 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
Aetna	$7 - $70	116%
Blue Cross Blue Shield	$36 - $61	599%
Evercare Mcaid	$60 - $61	998%
UnitedHealthcare	$65 - $97	1082%
Amerigroup Mcr Adv - All Other Plans	$70	1165%
Community Hlth Choice Him - All Other Plans	$70	1165%
Coventry Mcr Adv	$70	1165%
Molina Mcr Adv - All Other Plans	$70	1165%
Superior Hp Mcr Adv-All Other Plans	$70	1165%
Wellcare Mcare - All Plans	$70	1165%
Care Improvement Mcr - All Plans	$71	1181%
Choicecare Mcr Adv - All Plans	$71	1181%
Cigna	$78 - $79	1298%
Community Hlth Choice Star	$85 - $86	1414%
Molina Mcaid	$85 - $86	1414%
Superior Hp Mcaid	$85 - $86	1414%
Tx Chlidrens Hp Mcaid - All Plans	$85 - $86	1414%
Tx True Choice Mcaid - All Plans	$85 - $86	1414%
Beech Street - All Plans	$90 - $91	1498%
Community Care Network - All Plans	$96 - $97	1597%
Galaxy Health Network - All Plans	$108 - $109	1797%
Multiplan - All Plans	$108 - $109	1797%
Evercare Mcr Adv - All Other Plans	$117 - $118	1947%
Amerigroup Mcaid	$120 - $122	1997%

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 $73.
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 Sweeny Community 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.