Blood test, clotting time (PTT)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $61
- Cash Discount Price: $44
- vs. Medicare Baseline: 10.15x 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 1015% of the Medicare baseline (a markup of 915%). 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 |
|---|---|---|
| Lucent Health [6000] | $61 | 1015% |
| Healthcare Highways [2210] | $61 | 1015% |
| Aetna | $61 | 1015% |
| Oncology Patient Assistance Programs [2295] | $61 | 1015% |
| Hooray Health [8000] | $61 | 1015% |
| Black Lung [6055] | $61 | 1015% |
| Blue Cross Blue Shield | $61 | 1015% |
| Web Tpa [2115] | $61 | 1015% |
| Department Of Corrections [1340] | $74 | 1231% |
| National Association Of Letter Carriers [1695] | $85 | 1414% |
| Cigna | $85 | 1414% |
| Healthpartners [1500] | $85 | 1414% |
| American Postal Workers Union [1070] | $85 | 1414% |
| Humana | $87 | 1448% |
| Administrative Concepts [1005] | $115 | 1913% |
| Multiplan [1680] | $115 | 1913% |
| American Healthcare [1055] | $115 | 1913% |
| First Health [1375] | $115 | 1913% |
| Coventry Healthcare [1320] | $121 | 2013% |
| Ks Disability Determination [6090] | $148 | 2463% |
Consumer Guidance & Cost Commentary
For this blood clotting time test at the University of Kansas Health System - St Francis Campus, the facility's cash price of $44.00 is significantly lower than the state average of $148.00 and the county average of $148.00. While many insurance plans negotiate a rate of $61.00, which is higher than the cash price, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allowed amount exceeds the cash rate. It is important to note that while the facility is a voluntary non-profit church-owned acute care hospital in Topeka, KS, commercial negotiated rates often include administrative overhead that can inflate the baseline price by 20% to 40% compared to direct cash payments.
Patients should verify their specific plan details before scheduling, as assuming that an in-network rate is the lowest possible price can be misleading, as different insurers negotiate varying amounts. If you receive a bill that includes charges for services not rendered or unbundled components, you should request a formal itemized audit to identify errors, as over 80% of hospital bills contain mistakes. Additionally, if you are concerned about balance billing, remember that the No Surprises Act protects you from being billed for out-of-network emergency services or non-emergency services at in-network facilities, so you should never sign away your rights to dispute such bills without first reviewing your plan's network status and the specific services covered.