CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Prosser Memorial Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $81
Cash Discount Price: $57
vs. Medicare Baseline: 13.48x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Prosser Memorial Hospital is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 13.48x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.

Cash / Self-Pay

$57

Average discount available for prompt cash payment at this facility.

Insurance Median

$81

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: $57 (948%)

Insurance Median: $81 (1348%)

Cash: $57 (948% of Medicare)

Ins. Median: $81 (1348% 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 1348% of the Medicare baseline (a markup of 1248%). 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
UnitedHealthcare	$10 - $43	166%
Kaiser Permanente	$20 - $96	333%
Community Health Plan Of Washington	$22 - $43	366%
Coordinated Care	$22 - $43	366%
Amerigroup	$23 - $46	383%
Molina	$23 - $43	383%
Health Alliance Northwest	$25 - $26	416%
Wellcare	$25 - $26	416%
Humana	$26 - $90	433%
Aetna	$30 - $90	499%
Ambetter / Centene	$71 - $82	1181%
Asuris	$81 - $95	1348%
Health Management Adminstrators	$81 - $95	1348%
Premera	$81 - $85	1348%
Regence	$81 - $95	1348%
Cigna	$83 - $87	1381%
First Choice	$86 - $90	1431%
Multiplan	$86 - $95	1431%

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 $57.
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 Prosser Memorial 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.