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Heparin-Protamine Tolerance Test

Pennsylvania 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?

$12.30

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $12.30 for this service. The price depends on where it is billed: about $10.96 from a physician practice, and about $26.92 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$10.96$10.72 to $12.59
FacilityA hospital or hospital-owned outpatient department$26.92$15.85 to $38.90

How much rates vary

Facilitymedian $27 · 10th to 90th $11 to $63Professionalmedian $11 · 10th to 90th $10 to $24
$10$20$50$100facility $27professional $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
$11.22
Median
$26.92
Typical High
$48.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$10.96
Typical High
$30.90
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$74.13
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$10.23
Typical High
$10.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$9.33
Median
$19.95
Typical High
$44.67
Cigna
Setting
Professional
Modifier
Global
Typical Low
$8.32
Median
$17.78
Typical High
$34.67
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$6.17
Median
$7.76
Typical High
$19.05
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$13.18
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$13.18
Typical High
$22.91
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$26.92
Typical High
$48.98
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$11.22
Typical High
$38.90
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$51.29
Typical High
$89.13
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$13.18
Typical High
$14.45
United
Setting
Facility
Modifier
Global
Typical Low
$7.24
Median
$13.18
Typical High
$15.85
United
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$8.32
Typical High
$19.95

Where Pennsylvania 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.

Pennsylvania· 32nd of 51

$12.30

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.