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Heparin-Protamine Tolerance Test

North Carolina 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?

$10.47

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $10.47 for this service. The price depends on where it is billed: about $10.47 from a physician practice, and about $14.13 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$10.47$10.47 to $11.75
FacilityA hospital or hospital-owned outpatient department$14.13$11.22 to $29.51

How much rates vary

Facilitymedian $14 · 10th to 90th $10 to $44Professionalmedian $10 · 10th to 90th $9 to $17
$10$20$50$100facility $14professional $10

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
$10.47
Median
$12.59
Typical High
$43.65
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$10.47
Typical High
$17.38
BCBS
Setting
Facility
Modifier
Global
Typical Low
$23.44
Median
$60.26
Typical High
$60.26
BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.76
Median
$8.51
Typical High
$27.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$9.77
Median
$25.12
Typical High
$60.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.76
Median
$9.55
Typical High
$19.95
Medcost
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$72.44
Medcost
Setting
Facility
Modifier
Global
Typical Low
$7.76
Median
$14.13
Typical High
$27.54
Medcost
Setting
Professional
Modifier
Global
Typical Low
$10.47
Median
$18.20
Typical High
$19.95
United
Setting
Facility
Modifier
Global
Typical Low
$7.41
Median
$16.98
Typical High
$24.55
United
Setting
Professional
Modifier
Global
Typical Low
$6.61
Median
$10.00
Typical High
$19.95
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$112.20

Where North Carolina 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.

North Carolina· 48th of 51

$10.47

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.