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Heparin-Protamine Tolerance Test

Virginia 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 Virginia, July 2026.

Insurers have agreed to pay about $12.30 for this service. The price depends on where it is billed: about $9.77 from a physician practice, and about $15.49 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$9.77$9.55 to $12.30
FacilityA hospital or hospital-owned outpatient department$15.49$13.18 to $33.11

How much rates vary

Facilitymedian $15 · 10th to 90th $12 to $68Professionalmedian $10 · 10th to 90th $6 to $31
$10$100$1K$10Kfacility $15professional $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
$12.30
Median
$32.36
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$9.77
Median
$10.23
Typical High
$26.30
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$52.48
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$6.46
Median
$6.46
Typical High
$10.00
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$66.07
Typical High
$89.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$13.49
Median
$35.48
Typical High
$58.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$9.77
Typical High
$24.55
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$15.85
Typical High
$19.50
Medcost
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$23.99
Typical High
$27.54
Medcost
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$14.13
Typical High
$14.13
Medcost
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$16.22
Typical High
$27.54
Sentara
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$20.42
Typical High
$10,000.00
Sentara
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$19.95
Typical High
$10,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$13.18
Typical High
$24.55
United
Setting
Professional
Modifier
Global
Typical Low
$5.50
Median
$8.32
Typical High
$14.79

Where Virginia 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.

Virginia· 33rd 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.