Blood test, clotting time (PTT)
Facility: Pratt Regional Medical Center
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $48
- Cash Discount Price: $38
- vs. Medicare Baseline: 7.99x 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 799% of the Medicare baseline (a markup of 699%). 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 |
|---|---|---|
| Christian Health Aid | $41 | 682% |
| UnitedHealthcare | $45 - $55 | 749% |
| Health Partners Of Kansas | $46 | 765% |
| Aetna | $49 | 815% |
| Choicecare | $54 | 899% |
Consumer Guidance & Cost Commentary
For this blood clotting time test at Pratt Regional Medical Center in Pratt, KS, the cash price of $38.00 is notably lower than the facility's gross charge of $54.00 and the state average. While insurance plans like UnitedHealthcare and Health Partners Of Kansas have negotiated rates ranging from $45 to $55, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that commercial negotiated rates frequently include administrative overhead and are not always the lowest possible cost; in this case, the cash rate is significantly more affordable than the typical insurance allowed amounts.
Patients should verify their specific plan details before scheduling, as some commercial payers may not have contracts with this facility, potentially leading to balance billing if care is received out-of-network. Even if you are in-network, you should request an itemized bill to ensure no errors or unbundled charges exist, as over 80% of hospital bills contain mistakes that can be corrected. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the final cost if you settle the account quickly, and always compare the facility's rates against the Medicare benchmark of $6.01 to understand the true cost basis of the service.