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Heparin-Protamine Tolerance Test

Massachusetts 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?

$16.22

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $16.22 for this service. The price depends on where it is billed: about $13.18 from a physician practice, and about $32.36 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 8 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$13.18$13.18 to $19.95
FacilityA hospital or hospital-owned outpatient department$32.36$19.05 to $39.81

How much rates vary

Facilitymedian $32 · 10th to 90th $13 to $56Professionalmedian $13 · 10th to 90th $11 to $41
$10$50$200$1Kfacility $32professional $13

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
$13.49
Median
$30.20
Typical High
$56.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$13.49
Typical High
$63.10
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$18.62
Typical High
$112.20
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$7.76
Median
$13.18
Typical High
$31.62
BCBS
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$32.36
Typical High
$51.29
BCBS
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$18.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$10.23
Median
$21.88
Typical High
$36.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$15.85
Typical High
$34.67
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$16.22
Median
$112.20
Typical High
$7,079.46
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$18.62
Typical High
$21.88
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$40.74
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$18.62
Typical High
$112.20
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$7.76
Median
$13.18
Typical High
$31.62
United
Setting
Facility
Modifier
Global
Typical Low
$7.76
Median
$13.18
Typical High
$20.89
United
Setting
Professional
Modifier
Global
Typical Low
$7.76
Median
$12.30
Typical High
$33.88

Where Massachusetts 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.

Massachusetts· 13th of 51

$16.22

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.