Blood test, clotting time (PTT)
Facility: Menorah Medical Center
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $13
- Cash Discount Price: $467
- 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 |
|---|---|---|
| Cigna | $3 - $373 | 50% |
| United | $5 - $210 | 83% |
| Healthyblue | $5 | 83% |
| Aetna | $5 - $238 | 83% |
| Unicare | $5 | 83% |
| Amerigroup | $5 | 83% |
| Medicaid / KanCare | $5 | 83% |
| Humana | $6 - $15 | 100% |
| Blue Cross Blue Shield | $6 - $210 | 100% |
| Wellcare | $6 | 100% |
| Triwest Health Alliance | $6 | 100% |
| Home State Health Plan | $6 | 100% |
| Devoted Health | $6 | 100% |
| Pyramid Life | $6 | 100% |
| Celtic | $6 | 100% |
| Coventry | $6 - $188 | 100% |
| Oscar | $9 | 150% |
| Multiplan | $11 - $345 | 183% |
| Oha Network | $13 - $233 | 216% |
| Corvel Corporation | $13 - $303 | 216% |
| Ambetter / Centene | $87 | 1448% |
| Nhc Advantage | $89 | 1481% |
| Wppa Providrs Care Network | $93 | 1547% |
| Universal Healthcare | $163 | 2712% |
| Coventry Kc Mo | $191 | 3178% |
| College Park Family Care Center | $201 | 3344% |
| Cco, Inc. | $350 | 5824% |
| Focus Healthcare Mgmt, Inc | $350 | 5824% |
Consumer Guidance & Cost Commentary
For this blood clotting time test (CPT 85730) at Menorah Medical Center in Overland Park, KS, the cash price is $467.00, which matches the facility's cash median. This rate is significantly higher than the state average, as indicated by a 2.2x multiplier compared to Medicare's benchmark rate of $6.01. While commercial insurance negotiated rates range from $5 to $373 depending on the plan, patients with high-deductible plans may find paying the full cash price upfront more cost-effective if their insurance allowed amount exceeds $467.00. It is important to note that while the facility is a Proprietary Acute Care Hospital, patients should verify their specific plan's allowed amount before scheduling, as some in-network contracts may result in higher out-of-pocket costs than the cash rate.
To ensure you are not overcharged, we recommend requesting a full itemized bill before paying, as summary invoices often hide unbundled codes or services not rendered. If you receive a balance bill for the difference between the chargemaster and your insurance payment, you may be protected under the No Surprises Act, which bans balance billing for out-of-network services at in-network facilities. Additionally, ask the billing department about prompt-pay discounts, which can reduce the $467.00 cash price by 20% to 50% if paid in full within 30 days. Since over 80% of hospital bills contain errors, always dispute any discrepancies in writing rather than accepting a verbal settlement, and confirm that your specific test is covered before proceeding to avoid unexpected administrative fees.