Blood test, clotting time (PTT)
Facility: Centura St. Catherine-Dodge City
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $101
- Cash Discount Price: $61
- vs. Medicare Baseline: 16.81x 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 1681% of the Medicare baseline (a markup of 1581%). 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 | $6 - $122 | 100% |
| Kaiser | $6 | 100% |
| Medicare (plans) | $6 | 100% |
| Cigna | $6 | 100% |
| Kansas Health | $6 | 100% |
| Blue Cross Blue Shield | $6 - $26 | 100% |
| Humana | $6 | 100% |
| Centura Employee Plan | $8 | 133% |
| UnitedHealthcare | $101 | 1681% |
| Wpaa | $107 | 1780% |
| Multiplan | $122 - $138 | 2030% |
| Christian Health Aid | $122 | 2030% |
| Health Partners Of Kansas | $138 | 2296% |
Consumer Guidance & Cost Commentary
For the CPT code 85730, representing a blood test for clotting time (PTT), the facility's cash median price is $61.00, which is significantly lower than the state average of $120.00. While many commercial payers have negotiated rates ranging from $6 to $138, the cash price often serves as a more transparent baseline for patients with high-deductible plans or those who may not have insurance coverage. It is important to note that while commercial negotiated rates can sometimes exceed cash prices due to administrative overhead and contract structures, patients should verify their specific plan's allowed amount before scheduling. Additionally, patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final cost by bypassing the standard insurance billing cycle.
When evaluating this service, it is crucial to compare rates against the Medicare benchmark rather than the facility's gross chargemaster list, as Medicare rates represent a scientifically validated cost baseline. For this procedure, the Medicare amount is $6.01, and the facility's cash rate is approximately 10 times higher than the Medicare benchmark, which is consistent with typical commercial markups. However, the median negotiated rate across payers is $101.00, which is still higher than the cash price. To ensure you are not overpaying, request a detailed, itemized billing audit to confirm that all charges are accurate and that no unbundled codes or services not rendered have been included in your final statement.