Blood test, clotting time (PTT)
Facility: Ascension Via Christi Hospitals Wichita, Inc.
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $6
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.00x 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.
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 |
|---|---|---|
| Smarthealth | $5 - $8 | 83% |
| Saint Lukes Health Systems | $6 | 100% |
| Humana | $6 | 100% |
| Blue Cross Blue Shield | $6 | 100% |
| Vc Hope | $6 | 100% |
| Via Christi Research | $6 | 100% |
| Va | $6 | 100% |
| Medicare (plans) | $6 | 100% |
| UnitedHealthcare | $6 - $17 | 100% |
| Corizon | $8 | 133% |
| Medicaid / KanCare | $10 | 166% |
| Mdsave | $15 | 250% |
| Aetna | $19 | 316% |
| Coventry City Of Wichita | $24 | 399% |
Consumer Guidance & Cost Commentary
For the CPT code 85730, representing a blood test for clotting time (PTT), the facility Ascension Via Christi Hospitals Wichita, Inc. in Wichita, KS, reports a negotiated rate of $6.00. This amount is consistent with the Medicare benchmark of $6.01, indicating that the facility's contracted rate aligns closely with the federal government's cost-based baseline. Unlike commercial rates that often average 200% to 300% of Medicare, this negotiated figure reflects a pricing structure near the fair value range of 120% to 150% of the Medicare amount. Patients should note that while commercial negotiated rates can sometimes exceed cash prices due to administrative overhead, the facility's rate here matches the Medicare standard, suggesting no significant markup relative to the federal benchmark.
While the data does not provide specific cash or state/county average figures for this procedure, the facility's ownership as a voluntary non-profit private hospital may influence its pricing strategy. Consumers are encouraged to verify their specific plan details, as some high-deductible plans might find paying the cash price directly cheaper if the insurance negotiated rate exceeds their out-of-pocket threshold. Before scheduling, patients should explicitly request "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% by bypassing insurance claims processing fees. Additionally, since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients should ensure they receive an itemized bill to confirm all charges are accurate and that no unexpected ancillary services have triggered additional costs.