CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Columbus Community Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $100
Cash Discount Price: $80
vs. Medicare Baseline: 16.64x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Columbus Community Hospital is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 16.64x the Medicare baseline. Located in 1515 Park Ave, Columbus, WI.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $80 (1331%)

Insurance Median: $100 (1664%)

Cash: $80 (1331% of Medicare)

Ins. Median: $100 (1664% 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 1664% of the Medicare baseline (a markup of 1564%). 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	$6 - $117	100%
Dean Health Plan	$6 - $52	100%
Icare	$6 - $44	100%
My Choice Wisconsin	$6	100%
Quartz	$6 - $100	100%
Security Health Plan	$6 - $113	100%
UnitedHealthcare	$6 - $126	100%
Alliance	$17	283%
Cigna	$84 - $91	1398%
Health Payment Systems	$105 - $114	1747%
Trilogy	$115 - $125	1913%
Wps	$118 - $128	1963%
Healtheos	$122 - $141	2030%
First Health	$123 - $134	2047%
Humana	$126 - $137	2097%

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 $80.
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 Columbus 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.