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Clotting Protein Activity Test

New Jersey 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?

$30.20

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $30.20 for this service. The price depends on where it is billed: about $23.99 from a physician practice, and about $63.10 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 6 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$23.99$18.62 to $27.54
FacilityA hospital or hospital-owned outpatient department$63.10$39.81 to $178

How much rates vary

Facilitymedian $63 · 10th to 90th $26 to $282Professionalmedian $24 · 10th to 90th $12 to $65
$10$100$1K$10Kfacility $63professional $24

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
$26.92
Median
$46.77
Typical High
$223.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$6.46
Median
$23.99
Typical High
$64.57
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$83.18
Typical High
$3,162.28
Cigna
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$67.61
Typical High
$141.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$20.42
Typical High
$64.57
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$9.55
Median
$14.45
Typical High
$25.70
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$10,471.29
Typical High
$25,118.86
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$18.62
Typical High
$26.92
United
Setting
Facility
Modifier
Global
Typical Low
$14.45
Median
$30.90
Typical High
$64.57
United
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$18.62
Typical High
$33.88

Where New Jersey sits

The same service costs 2.8 times more in South Dakota than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Jersey· 31st of 51

$30.20

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.