Blood test, clotting time (PTT)
Facility: Kansas Surgery & Recovery Center
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $6
- Cash Discount Price: $22
- 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 |
|---|---|---|
| UnitedHealthcare | $3 - $6 | 50% |
| Blue Cross Blue Shield | $6 - $15 | 100% |
| Triwest | $6 | 100% |
| Aetna | $6 - $18 | 100% |
| Cigna | $10 | 166% |
Consumer Guidance & Cost Commentary
For the CPT code 85730, representing a blood test for clotting time (PTT), Kansas Surgery & Recovery Center in Wichita, KS, lists a cash median price of $22.00. This cash rate is notably higher than the Medicare benchmark of $6.01, which serves as the federal baseline for the true cost of this service. While the facility offers a negotiated rate of $6.00 to participating insurers, patients should be aware that commercial insurance rates often exceed cash prices due to administrative overhead and contract structures. If you have a high-deductible plan, paying the cash price of $22.00 upfront might result in lower out-of-pocket costs compared to your insurance's negotiated rate, especially if your deductible has not yet been met.
To ensure you are not overcharged, it is critical to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Additionally, you should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final amount by 20% to 50% if paid in full within a short window. If you receive a balance bill for the difference between the provider's charge and your insurance's allowed amount, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities. Always verify your specific plan details and deductibles before scheduling to avoid unexpected financial burdens.