CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Beloit Health System

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $67
Cash Discount Price: $34
vs. Medicare Baseline: 11.15x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Beloit Health System is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 11.15x the Medicare baseline. Located in 1969 W Hart Rd, Beloit, WI.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

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: $34 (566%)

Insurance Median: $67 (1115%)

Cash: $34 (566% of Medicare)

Ins. Median: $67 (1115% 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 1115% of the Medicare baseline (a markup of 1015%). 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
Aetna	$6 - $319	100%
Blue Cross Blue Shield	$6 - $178	100%
Cook Children'S Health Plan (Cchp)	$6 - $168	100%
Dean Health	$6 - $188	100%
Humana	$6 - $23	100%
Independent Care Health Plan	$6	100%
Managed Health Services	$6	100%
Molina Healthcare	$6	100%
Quartz	$6 - $218	100%
UnitedHealthcare	$6 - $252	100%
Wellcare	$6	100%
Naphcare	$9	150%
Wea Trust	$14 - $185	233%
Wps	$18 - $249	300%
Multiplan	$20 - $269	333%
Health Eos	$22 - $306	366%
Cigna	$23 - $319	383%
Hfn	$23 - $319	383%
Preferred Network Access	$23 - $319	383%
The Alliance	$25	416%

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 $34.
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 Beloit Health System 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.