CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Vandalia Health Broaddus Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $65
Cash Discount Price: $116
vs. Medicare Baseline: 10.82x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Vandalia Health Broaddus Hospital is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 10.82x the Medicare baseline. Located in 1 Healthcare Drive Mansfield Hill, Philippi, WV.

Cash / Self-Pay

$116

Average discount available for prompt cash payment at this facility.

Insurance Median

$65

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: $116 (1930%)

Insurance Median: $65 (1082%)

Cash: $116 (1930% of Medicare)

Ins. Median: $65 (1082% 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 1082% of the Medicare baseline (a markup of 982%). 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 - $235	83%
Blue Cross Blue Shield	$11 - $187	183%
Peak Health	$12 - $84	200%
Highmark	$49 - $193	815%
The Health Plan	$50 - $237	832%
UnitedHealthcare	$50 - $255	832%
Humana	$52 - $202	865%
West Virginia Senior Advantage	$52 - $204	865%
Cigna	$59 - $230	982%
First Health	$60 - $235	998%
Geisenger Health Plan	$62 - $245	1032%
Health Network America	$62 - $250	1032%
Multiplan/Phcs	$63 - $247	1048%
Geha	$64 - $250	1065%
Selectnet	$66 - $258	1098%

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 $116.
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 Vandalia Health Broaddus 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.