Blood test, clotting time (PTT)
Facility: Overland Park Reg Med Ctr
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $90
- Cash Discount Price: $511
- vs. Medicare Baseline: 14.98x 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 1498% of the Medicare baseline (a markup of 1398%). 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 |
|---|---|---|
| Cigna | $3 - $6 | 50% |
| Healthyblue | $5 | 83% |
| Medicaid / KanCare | $5 | 83% |
| United | $5 - $241 | 83% |
| Aetna | $5 - $273 | 83% |
| Unicare | $5 | 83% |
| Amerigroup | $5 | 83% |
| Pyramid Life | $6 | 100% |
| Devoted Health | $6 | 100% |
| Wellcare | $6 | 100% |
| Humana | $6 - $15 | 100% |
| Home State Health Plan | $6 | 100% |
| Coventry | $6 - $215 | 100% |
| Triwest Health Alliance | $6 | 100% |
| Celtic | $6 | 100% |
| Blue Cross Blue Shield | $6 - $230 | 100% |
| Oscar | $9 | 150% |
| Multiplan | $11 - $396 | 183% |
| Oha Network | $13 - $268 | 216% |
| Corvel Corporation | $13 - $348 | 216% |
| Ambetter / Centene | $90 - $100 | 1498% |
| Nhc Advantage | $92 - $102 | 1531% |
| Wppa Providrs Care Network | $97 - $107 | 1614% |
| Universal Healthcare | $170 - $187 | 2829% |
| Coventry Kc Mo | $199 - $219 | 3311% |
| College Park Family Care Center | $209 - $230 | 3478% |
| Cco, Inc. | $365 - $401 | 6073% |
| Focus Healthcare Mgmt, Inc | $365 - $401 | 6073% |
Consumer Guidance & Cost Commentary
For this blood clotting time test (CPT 85730) at Overland Park Reg Med Ctr, the cash price is $511.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state of Kansas average, which is $6.01, and also exceeds the Medicare benchmark of $6.01. While commercial insurance contracts often cap charges, the data shows that the negotiated rates for this service range widely, with some payers like Cigna and Healthyblue negotiating amounts as low as $3.00 to $6.00, while others like Multiplan and Corvel Corporation have negotiated rates exceeding $100.00. Patients should be aware that while insurance networks provide a ceiling on charges, the actual amount paid can vary drastically depending on the specific plan and contract tier, sometimes resulting in a final bill that is still much higher than the cash price.
Because the cash price of $511.00 is lower than the highest negotiated rates found in the data, patients with high-deductible plans or those who have not yet met their out-of-pocket maximum may find it financially advantageous to pay the facility directly. To maximize savings, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling the test, as these upfront payment incentives can reduce the final cost by 20% to 50%. It is also important to request a full itemized bill to ensure no errors exist, as over 80% of hospital bills contain mistakes that can be corrected. Finally, if a patient has insurance, they must verify their deductible status beforehand, as using an