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Heparin-Protamine Tolerance Test

Maine 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?

$13.18

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $13.18 for this service. The price depends on where it is billed: about $13.18 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$13.18$10.00 to $13.18
FacilityA hospital or hospital-owned outpatient department$21.38$13.18 to $58.88

How much rates vary

Facilitymedian $21 · 10th to 90th $13 to $132Professionalmedian $13 · 10th to 90th $7 to $18
$5$10$20$50$100facility $21professional $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
$13.18
Median
$13.18
Typical High
$58.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$10.72
Typical High
$13.18
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$15.14
Median
$131.83
Typical High
$144.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.25
Median
$7.41
Typical High
$18.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$16.98
Median
$19.95
Typical High
$29.51
Cigna
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$13.18
Typical High
$19.95
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$13.18
Typical High
$15.85
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$58.88
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$13.18
Typical High
$32.36
United
Setting
Professional
Modifier
Global
Typical Low
$7.76
Median
$13.18
Typical High
$28.84

Where Maine 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.

Maine· 30th of 51

$13.18

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.