CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Charleston Area Medical Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $86
Cash Discount Price: $98
vs. Medicare Baseline: 14.31x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Charleston Area Medical Center is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 14.31x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$98

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $98 (1631%)

Insurance Median: $86 (1431%)

Cash: $98 (1631% of Medicare)

Ins. Median: $86 (1431% 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 1431% of the Medicare baseline (a markup of 1331%). 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	$5 - $98	83%
The Health Plan Of West Virginia Inc.	$5 - $97	83%
Unicare Health Plan Of West Virginia Inc.	$5 - $6	83%
Blue Cross Blue Shield	$6 - $91	100%
Choicecare Network	$6 - $98	100%
Optimum Choice Inc.	$6	100%
Triwest Va	$6	100%
UnitedHealthcare	$6 - $98	100%
West Virginia Senior Advantage Inc.	$6	100%
Integrated Medical Solutions	$12	200%
Naphcare	$12	200%
Caresource	$15	250%
Tricare	$54 - $60	899%
City Of Charleston	$68 - $75	1131%
Cigna	$84 - $93	1398%
Three Rivers Providers Network	$87 - $97	1448%
Healthsmart	$88 - $98	1464%
Multiplan	$88 - $98	1464%

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 $98.
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 Charleston Area Medical Center 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.