Blood test, clotting time (PTT)
Facility: Wesley Medical Center
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $13
- Cash Discount Price: $535
- vs. Medicare Baseline: 2.16x 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 216% of the Medicare baseline (a markup of 116%). 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 |
|---|---|---|
| Aetna | $5 - $191 | 83% |
| Medicaid / KanCare | $5 | 83% |
| Amerigroup | $5 | 83% |
| UnitedHealthcare | $5 | 83% |
| Humana | $6 | 100% |
| Triwest Health Alliance | $6 | 100% |
| Coventry Health Care | $6 | 100% |
| United | $6 - $241 | 100% |
| Ambetter / Centene | $6 - $96 | 100% |
| Devoted Health | $6 | 100% |
| Correct Care Solutions | $9 | 150% |
| First Health | $13 - $247 | 216% |
| Multiplan | $13 - $482 | 216% |
| Blue Cross Blue Shield | $17 | 283% |
| Wppa | $93 | 1547% |
| Health Partners Of Kansas | $93 - $268 | 1547% |
| Preferred Health Choices | $101 | 1681% |
| Medical Associates Health Plan | $101 | 1681% |
| Spirit Aerosystems | $171 | 2845% |
| Triwest Healthcare Alliance | $348 | 5790% |
| Usa Managed Care | $455 | 7571% |
Consumer Guidance & Cost Commentary
For the CPT code 85730, representing a blood test for clotting time (PTT), the cash price at Wesley Medical Center in Wichita, KS, is $535.00. This cash rate aligns exactly with the facility's cash median and is significantly higher than the Medicare benchmark of $6.01, reflecting a markup of 2.2 times the federal baseline. While commercial negotiated rates vary widely among the 21 payers represented in this report—ranging from a low of $5.00 to a high of $455.00—the median negotiated amount across all plans is $13.00. It is important to note that for patients with high-deductible plans, paying the cash price of $535.00 upfront may sometimes be more cost-effective than relying on insurance, as the insurer's negotiated rate often includes administrative overhead that can exceed the cash price.
Patients should proactively contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid in full before or shortly after the service. Additionally, while the facility is in-network for many carriers, the specific allowed amounts vary by plan, so verifying your individual deductible status and allowed amount before scheduling is crucial to avoid unexpected out-of-pocket costs. If you receive a bill, always request a full itemized statement showing specific CPT codes rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled charges that can be corrected through a formal written audit dispute.