CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Forks Community Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $89
Cash Discount Price: $136
vs. Medicare Baseline: 14.81x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Forks Community Hospital is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 14.81x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$136

Average discount available for prompt cash payment at this facility.

Insurance Median

$89

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: $136 (2263%)

Insurance Median: $89 (1481%)

Cash: $136 (2263% of Medicare)

Ins. Median: $89 (1481% 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 1481% of the Medicare baseline (a markup of 1381%). 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 - $144	166%
Medicaid / KanCare	$59 - $62	982%
Coordinated Care (Mco) Mcd-All Plans	$64	1065%
Community Health Network Mcr-All Other Plans	$76	1265%
Humana	$76	1265%
Tricare	$76	1265%
Triwest-All Plans	$76	1265%
Ambetter / Centene	$89	1481%
Wellcare Med Adv - All Plans	$89	1481%
Regence-All Other Plans	$98	1631%
Community Health Exchange	$110	1830%
Molina Commercial-All Other Plans	$156	2596%
Aetna	$162	2696%
Blue Cross Blue Shield	$162	2696%
Cigna	$170	2829%
First Choice-All Plans	$170	2829%
Medicare (plans)	$318	5291%

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 $136.
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 Forks 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.