Blood test, clotting time (PTT)
Facility: St. Catherine Hospital - Garden City
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $27
- Cash Discount Price: $63
- vs. Medicare Baseline: 4.49x 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 449% of the Medicare baseline (a markup of 349%). 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 |
|---|---|---|
| Humana | $6 | 100% |
| Innovage | $6 | 100% |
| UnitedHealthcare | $6 - $52 | 100% |
| Medicare (plans) | $6 | 100% |
| Aetna | $6 - $71 | 100% |
| Devoted Health | $6 | 100% |
| Kansas Health | $6 | 100% |
| Cigna | $6 - $8 | 100% |
| Blue Cross Blue Shield | $6 - $27 | 100% |
| Kaiser | $6 - $64 | 100% |
| Centura Employee Plan | $8 | 133% |
| United Colorado Doctor'S Plan | $9 | 150% |
| Direct To Employer | $11 - $93 | 183% |
| Denver Health | $55 | 915% |
| Wpaa | $59 | 982% |
| Christian Health Aid | $67 | 1115% |
| Multiplan | $76 - $198 | 1265% |
| Health Partners Of Kansas | $81 | 1348% |
| Peak Health | $91 | 1514% |
Consumer Guidance & Cost Commentary
This blood test for clotting time (PTT) at St. Catherine Hospital in Garden City, Kansas, has a cash median price of $63.00, which is significantly lower than the facility's negotiated rates ranging from $27.00 to $198.00 depending on the insurance plan. While many commercial payers like UnitedHealthcare and Aetna negotiate rates between $6.00 and $81.00, the cash price remains the most affordable option for patients without insurance or those with high-deductible plans. It is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures; for instance, the median negotiated rate of $27.00 is still higher than the cash median, and some plans like Multiplan have negotiated rates as high as $198.00. Patients should verify their specific plan's allowed amount before scheduling, as assuming in-network coverage guarantees the lowest price is a common pitfall that can lead to unexpected costs.
For patients seeking to minimize out-of-pocket expenses, requesting an itemized billing audit is the most effective way to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. If you receive a summary bill showing broad categories like "Laboratory," insist on a full line-by-line statement before paying or negotiating. Additionally, ask the hospital about prompt-pay discounts, which can reduce the cash price by 20% to 50% if you pay upfront, bypassing the costly insurance claims cycle. While the Medicare benchmark for this service is $6.01, commercial rates often run 200