Blood test, clotting time (PTT)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $6
- Cash Discount Price: $24
- 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% |
| UnitedHealthcare | $5 - $17 | 83% |
| Aetna | $5 | 83% |
| Medicaid / KanCare | $5 - $6 | 83% |
| Humana | $6 | 100% |
| Va | $6 | 100% |
| Medicare (plans) | $6 | 100% |
| Providrs Care | $6 | 100% |
| Ambetter / Centene | $10 | 166% |
| Blue Cross Blue Shield | $26 - $88 | 433% |
Consumer Guidance & Cost Commentary
For this blood clotting time test at Ascension Via Christi Hospital Manhattan, Inc, the cash price of $24.00 is significantly lower than the facility's negotiated rates, which range from $6.00 to $88.00 depending on the insurance plan. While the facility's cash rate is competitive, it is important to note that many commercial payers, including Blue Cross Blue Shield, have negotiated rates that exceed the cash price. This dynamic can be advantageous for patients with high-deductible plans or those who have not yet met their out-of-pocket maximum, as paying the cash price upfront may result in lower total costs compared to the insurance negotiated amount. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing the administrative overhead associated with insurance claims processing.
The facility's pricing is benchmarked against Medicare, which sets a fixed reimbursement rate of $6.01 for this procedure. The cash price of $24.00 represents a markup of 1.0 times the Medicare rate, indicating that the cash price is aligned with the facility's cost basis rather than inflated commercial markups. When comparing to broader market standards, the facility's cash rate is notably lower than the highest negotiated rates observed for this service, such as those from Blue Cross Blue Shield, which can reach up to $88.00. To ensure you are receiving the most accurate pricing, we recommend requesting an itemized bill to review specific CPT codes and avoid summary bills that may obscure individual charges. If you encounter unexpected billing discrepancies, such as unbundled services or charges for items not rendered, you have the right