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Heparin-Protamine Tolerance Test

New Jersey 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 New Jersey, July 2026.

Insurers have agreed to pay about $16.60 for this service. The price depends on where it is billed: about $11.22 from a physician practice, and about $28.84 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 5 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$11.22$10.23 to $16.60
FacilityA hospital or hospital-owned outpatient department$28.84$21.38 to $79.43

How much rates vary

Facilitymedian $29 · 10th to 90th $13 to $195Professionalmedian $11 · 10th to 90th $9 to $41
$10$100$1K$10Kfacility $29professional $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
$16.60
Median
$32.36
Typical High
$93.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$11.22
Typical High
$40.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$15.14
Median
$28.84
Typical High
$60.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$7.76
Median
$13.80
Typical High
$39.81
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$5.25
Median
$6.61
Typical High
$15.85
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$10,715.19
Typical High
$25,118.86
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.76
Median
$12.88
Typical High
$15.85
United
Setting
Facility
Modifier
Global
Typical Low
$6.17
Median
$13.18
Typical High
$26.92
United
Setting
Professional
Modifier
Global
Typical Low
$5.50
Median
$7.76
Typical High
$19.95

Where New Jersey 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.

New Jersey· 11th 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.