CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Black River Memorial Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $98
Cash Discount Price: $95
vs. Medicare Baseline: 16.31x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Black River Memorial Hospital is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 16.31x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$95

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $95 (1581%)

Insurance Median: $98 (1631%)

Cash: $95 (1581% of Medicare)

Ins. Median: $98 (1631% 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 1631% of the Medicare baseline (a markup of 1531%). 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	$3 - $54	50%
Group Health Cooperative Of Eau Claire	$6 - $103	100%
My Choice Wisconsin, Inc.	$6 - $54	100%
Quartz Health Solutions, Inc	$6 - $96	100%
UnitedHealthcare	$6 - $100	100%
Humana	$54 - $99	899%
Security Health Plan	$54 - $99	899%
Corvel	$65	1082%
The Alliance	$90 - $102	1498%
Triology Health Solutions	$95 - $101	1581%
Medica	$99	1647%
Association Benefits Solution	$101	1681%
Family Health Center Of Marshfield	$101	1681%
First Health Group Corporation	$101	1681%
Provider Network Of America	$101	1681%
Cigna	$103	1714%
Cofinity	$103	1714%
Coventry Health Care	$103	1714%
Custom Benefit Administrators	$103	1714%
Healthpartners, Inc.	$103	1714%
Multiplan	$103 - $105	1714%
Wisconsin Physicians Service Insurance Corp	$103	1714%
Chorus	$104	1730%

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 $95.
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 Black River 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.