Blood test, clotting time (PTT)
Facility: Salina Regional Health Center
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $74
- Cash Discount Price: $64
- vs. Medicare Baseline: 12.31x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $6.01 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 1231% of the Medicare baseline (a markup of 1131%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $14 - $15 | 233% |
| Preferred Phsic | $15 - $70 | 250% |
| Preferred Healthcare - All Other Plans | $20 - $95 | 333% |
| Cigna | $22 - $105 | 366% |
| Providers Care (Wppa)-All Plans | $22 - $105 | 366% |
| Multiplan (Mpi)-All Plans | $22 - $105 | 366% |
| Aetna | $22 - $105 | 366% |
Consumer Guidance & Cost Commentary
For the CPT code 85730, representing a blood test for clotting time (PTT), Salina Regional Health Center in Salina, KS, lists a cash median price of $64.00 and a median negotiated rate of $74.00. While the facility's cash price is lower than its negotiated rates, it is important to note that commercial insurance contracts often result in higher out-of-pocket costs for patients with high deductibles, as the negotiated ceiling can exceed the cash price. The facility is a voluntary non-profit acute care hospital located at 400 South Santa Fe Avenue, and patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling to potentially reduce the final amount owed.
When evaluating the value of this service, it is critical to compare rates against the Medicare benchmark rather than the hospital's gross chargemaster. The Medicare amount for this procedure is $6.01, and the facility's negotiated rate represents a significant markup above this federal baseline. Additionally, the data indicates a "vs_medicare" metric of 12.3, which reflects the relationship between the facility's pricing and the national average. To ensure you are not overpaying, you should request a full itemized bill to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.