CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Ascension Seton Hays

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $17
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 2.83x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Ascension Seton Hays is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 2.83x the Medicare baseline. Located in 6001 Kyle Pkwy, Kyle, TX.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $36 (599%)
Insurance Median: $17 (283%)
Cash: $36 (599% of Medicare)
Ins. Median: $17 (283% 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 283% of the Medicare baseline (a markup of 183%). 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
Ambetter / Centene $5 - $11 83%
Blue Cross Blue Shield $5 - $28 83%
Dell Chip/Chip Perinate $5 - $6 83%
Dell Star $5 - $6 83%
UnitedHealthcare $5 - $6 83%
Wellpoint Chip/Chip Perinate $5 - $6 83%
Wellpoint Star Kids $5 83%
Wellpoint Star Plus $5 - $6 83%
Aarp Mc Wellmed $6 100%
Addr Cancer Together $6 100%
Aetna $6 - $45 100%
Connected Senior Care $6 100%
Covid Hrsa $6 100%
Cshcn Cidc $6 100%
Devoted Health Mcr Replacement $6 100%
Humana $6 - $10 100%
Medicare (plans) $6 100%
Pphp Mcr Advantage $6 100%
Research Study $6 100%
Sendero Chap $6 100%
Smarthealth $6 100%
Superior Allwell $6 100%
Tricare $6 100%
Tx Independence Hp $6 100%
Utmb $6 100%
Wellcare Med Advantage $6 100%
Wellpoint Star $6 100%
Champva $7 - $8 116%
Occunet $8 133%
Sendero Idealcare $11 183%
Superior Star $11 - $91 183%
Superior Star Foster $11 - $91 183%
Superior Star Kids $11 - $91 183%
Superior Star Plus $11 - $91 183%
Superior Chip/Chip Perinate $13 - $102 216%
Cigna $14 233%
Seton Performance Plus $15 250%
Covenant Health $33 549%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6001 Kyle Pkwy, Kyle, TX 78640
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals