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Clotting Protein Activity Test

North Carolina rates for HCPCS 85397

A blood test that measures how well a particular protein involved in forming or dissolving clots is actually working, rather than simply how much of it is present. It is used when a specific measurement is needed that no standard named test covers.

Rates data updated July 2026.

How much does Clotting Protein Activity Test cost?

$28.84

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $28.84 for this service. The price depends on where it is billed: about $24.55 from a physician practice, and about $93.33 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$24.55$22.39 to $26.92
FacilityA hospital or hospital-owned outpatient department$93.33$28.18 to $166

How much rates vary

Facilitymedian $93 · 10th to 90th $25 to $269Professionalmedian $25 · 10th to 90th $17 to $39
$10.0$20.0$50.0$100.0$200.0facility $93professional $25

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$24.55
Median
$93.33
Typical High
$269.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$24.55
Typical High
$38.90
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$16.60
Median
$19.50
Typical High
$19.50
BCBS
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$70.79
Typical High
$102.33
BCBS
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$19.05
Typical High
$19.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$20.89
Median
$60.26
Typical High
$141.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$14.45
Median
$16.22
Typical High
$41.69
Medcost
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$44.67
Medcost
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$22.39
Typical High
$32.36
Medcost
Setting
Professional
Modifier
Global
Typical Low
$8.32
Median
$8.32
Typical High
$8.91
United
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$32.36
Typical High
$39.81
United
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$16.60
Typical High
$33.88
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91

Where North Carolina sits

The same service costs 2.8 times more in South Dakota than in Florida. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

North Carolina $28.84 · 35th of 51
SD $58.88FL $21.38

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.