CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $57
  • Cash Discount Price: $55
  • vs. Medicare Baseline: 9.48x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at University of Wi Hospitals & Clinics Authority is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 9.48x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.
Cash / Self-Pay
$55

Average discount available for prompt cash payment at this facility.

Insurance Median
$57

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: $55 (915%)
Insurance Median: $57 (948%)
Cash: $55 (915% of Medicare)
Ins. Median: $57 (948% 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 948% of the Medicare baseline (a markup of 848%). 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
Aetna $6 - $79 100%
Blue Cross Blue Shield $6 - $93 100%
Humana $6 100%
Medicare (plans) $6 100%
UnitedHealthcare $6 - $62 100%
Alliance_Premier_Network $41 - $47 682%
Mercycare $43 - $49 715%
Triology $44 - $60 732%
Security_Health_Plan $46 - $62 765%
Employer'S_Coalition_On_Health $47 - $76 782%
Alliance $48 - $55 799%
Hfn $49 - $76 815%
United_Healthcare $49 - $83 815%
Aspirus_Health_Plan $50 - $57 832%
Beloit_Health_System $50 - $57 832%
Cigna $51 - $59 849%
Health_Partners_Insurance $52 - $60 865%
Health_Payment_Systems $53 - $60 882%
Dean_Health_Plan $55 - $63 915%
Medical_Associates $57 - $65 948%
Wps $59 - $75 982%
Employers_Healthcare_Coalition_Of_Wi $60 - $69 998%
Aspirus_Network_Inc $66 - $76 1098%
Chorus_Community $69 - $79 1148%
Ghc_Eau_Claire_Health_Plan $69 - $79 1148%
Multiplan $69 - $90 1148%
Sheybogan_Employers_Health_Network $69 - $79 1148%
Coventry $73 - $84 1215%
Dean_Care $73 - $84 1215%
Healthsmart $75 - $86 1248%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Highland Avenue, Madison, WI 53792
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals