CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Childrens Hospital of the Kings Daughters Inc

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $52
Cash Discount Price: $61
vs. Medicare Baseline: 8.65x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Childrens Hospital of the Kings Daughters Inc is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 8.65x the Medicare baseline. Located in 601 Children's Lane, Norfolk, VA.

Cash / Self-Pay

$61

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $61 (1015%)

Insurance Median: $52 (865%)

Cash: $61 (1015% of Medicare)

Ins. Median: $52 (865% 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 865% of the Medicare baseline (a markup of 765%). 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
Blue Cross Blue Shield	$5 - $12	83%
UnitedHealthcare	$5 - $64	83%
Johns Hopkins Healthcare	$6	100%
Aetna	$7 - $64	116%
Humana	$7	116%
Amerihealth Caritas	$11	183%
Carolina Complete Health	$11	183%
Healthy Blue	$11	183%
Wellcare	$11	183%
Cigna	$38 - $52	632%
Virginia Health Network	$40 - $63	666%
Medcost	$49 - $72	815%
First Health	$52 - $70	865%
Multiplan	$53 - $72	882%
Phcs	$53 - $74	882%
Vhn	$53 - $74	882%

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 $61.
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 Childrens Hospital of the Kings Daughters Inc 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.