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Heparin-Protamine Tolerance Test

Illinois rates for HCPCS 85530

A laboratory test that works out how much protamine, the drug used to reverse heparin, is needed to neutralize the heparin present in a blood sample. It gives a direct measure of how much heparin effect the blood is carrying.

Rates data updated July 2026.

How much does Heparin-Protamine Tolerance Test cost?

$16.60

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $16.60 for this service. The price depends on where it is billed: about $11.48 from a physician practice, and about $21.38 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$11.48$10.47 to $20.42
FacilityA hospital or hospital-owned outpatient department$21.38$13.80 to $30.20

How much rates vary

Facilitymedian $21 · 10th to 90th $11 to $59Professionalmedian $11 · 10th to 90th $10 to $35
$10$20$50$100facility $21professional $11

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
$10.72
Median
$20.42
Typical High
$35.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$11.22
Typical High
$27.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$17.78
Median
$38.90
Typical High
$134.90
BCBS
Setting
Professional
Modifier
Global
Typical Low
$9.12
Median
$10.00
Typical High
$10.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$15.49
Median
$30.20
Typical High
$58.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.92
Median
$15.14
Typical High
$23.44
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$27.54
Typical High
$151.36
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$16.98
Typical High
$16.98
Molina
Setting
Professional
Modifier
Global
Typical Low
$7.24
Median
$7.24
Typical High
$7.24
United
Setting
Facility
Modifier
Global
Typical Low
$8.32
Median
$13.18
Typical High
$26.30
United
Setting
Professional
Modifier
Global
Typical Low
$5.50
Median
$8.32
Typical High
$13.18

Where Illinois sits

The same service costs 2.6 times more in Hawaii than in Maryland. 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.

Illinois· 10th of 51

$16.60

HI $25.70MD $9.77

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.