Blood test, clotting time (PTT)
Facility: University Of Kansas Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $112
- Cash Discount Price: $36
- vs. Medicare Baseline: 18.64x 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 1864% of the Medicare baseline (a markup of 1764%). 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 |
|---|---|---|
| Larned State Hospital [503200090] | $16 - $55 | 266% |
| Health Plan Inc [503999941] | $26 - $87 | 433% |
| Alt Carelon Behavioral Health [503200905] | $28 - $92 | 466% |
| Accarent Health [503999034] | $28 - $92 | 466% |
| Php [503200005] | $33 - $137 | 549% |
| Cerner [503200038] | $33 - $112 | 549% |
| Allied National [503999937] | $33 - $111 | 549% |
| Inter-Americas Insurance [503999032] | $33 - $112 | 549% |
| Med-Pay [503200040] | $33 - $112 | 549% |
| Alt Wppa [5032000964] | $33 - $112 | 549% |
| Healthlink [503200007] | $33 - $137 | 549% |
| Geha [503200036] | $33 - $112 | 549% |
| Cigna | $35 - $148 | 582% |
| Aha-Healthcare Preferred [503200050] | $36 - $122 | 599% |
| First Health [5032000110] | $36 - $122 | 599% |
| Consolidated Billing [50311256] | $38 - $130 | 632% |
| Blue Cross Blue Shield | $38 - $142 | 632% |
| Coeur Plan Services [503301517] | $38 - $130 | 632% |
| Ascension Living Hope [503201517] | $38 - $130 | 632% |
| Correct Care Solutions [50311253] | $38 - $130 | 632% |
| Orscheln Industries [503201608] | $41 - $139 | 682% |
| Empire Plan/Nyship [503200705] | $42 - $142 | 699% |
| Alt Lucent Health Solutions [503202603] | $42 - $142 | 699% |
| Alt Lineco [5032000976] | $42 - $142 | 699% |
| Point Comfort Underwriters [503200018] | $44 - $148 | 732% |
| Century Health Solutions [503200054] | $44 - $148 | 732% |
| Quiktrip [5032000412] | $44 - $148 | 732% |
| Meritain Health [503200039] | $46 - $155 | 765% |
| Wppa [503200056] | $46 - $155 | 765% |
| Three Rivers Provider Network [503999029] | $50 - $166 | 832% |
| Employers Health Network [503999025] | $50 - $166 | 832% |
| Plan Care America [503999026] | $50 - $166 | 832% |
| Usa Managed Care [503999030] | $50 - $166 | 832% |
| Sanford Health Plan [503999027] | $50 - $166 | 832% |
| Workers Comp [503999901] | $52 - $176 | 865% |
Consumer Guidance & Cost Commentary
For the blood test, clotting time (PTT) service at University Of Kansas Hospital, the facility's cash price of $36.00 is significantly lower than the state average of $182.00, offering a substantial discount for patients paying out-of-pocket. While the facility's negotiated rates with insurance plans range from $26 to $176, these amounts often exceed the cash price due to administrative costs and contract structures; for instance, the median negotiated rate of $112.00 is more than three times the cash price. This pricing dynamic suggests that patients with high-deductible plans or those without insurance may save money by paying the cash rate directly, provided they verify the facility's "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can bypass the higher administrative fees embedded in insurance billing cycles.
The facility's pricing also compares favorably against federal benchmarks, with the cash price of $36.00 being roughly 60% of the Medicare amount of $60.10, indicating a transparent and efficient cost structure relative to the government's fixed reimbursement rates. Although the facility is an Acute Care Hospital in Kansas City, KS, with a government ownership status, the variation in negotiated rates across 35 different payers highlights that in-network status does not guarantee the lowest possible price. To ensure you are not overcharged, it is advisable to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected through a formal written dispute sent to the billing supervisor.