Blood test, clotting time (PTT)
Facility: Kansas Heart Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $6
- Cash Discount Price: $25
- 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 |
|---|---|---|
| Aetna | $2 | 33% |
| Tricare | $5 | 83% |
| UnitedHealthcare | $6 | 100% |
| Humana | $6 | 100% |
| Celtic Mcr Adv | $6 | 100% |
| Medicaid / KanCare | $6 | 100% |
| Blue Cross Blue Shield | $15 | 250% |
| Wppa - All Plans | $16 | 266% |
| Multiplan - All Plans | $36 | 599% |
Consumer Guidance & Cost Commentary
For CPT code 85730, a blood test for clotting time (PTT), Kansas Heart Hospital in Wichita, KS, lists a gross charge of $40.00. The facility's cash median price is $25.00, which is lower than the negotiated rates paid by most major payers, including Aetna, Tricare, and UnitedHealthcare. While the facility's negotiated rate averages $6.00 across its nine payer contracts, this figure is significantly lower than the cash price, suggesting that for patients with high-deductible plans or those without insurance, paying the cash median of $25.00 upfront may result in lower out-of-pocket costs compared to insurance claims that could exceed this amount. Patients should verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can bypass administrative fees and reduce the final bill.
The facility's pricing is benchmarked against the federal Medicare rate of $6.01, which serves as an objective baseline for healthcare costs. Although the facility's negotiated rates are lower than the cash price, it is important to note that commercial rates often include administrative overhead and contract dynamics that can inflate costs relative to the true cost of care represented by Medicare. If a patient receives care from out-of-network providers within this facility, they may face balance billing for the difference between the provider's full charge and the insurance allowed amount, though the No Surprises Act protects against such surprise bills for emergency and non-emergency services at in-network hospitals. To ensure accuracy, patients should request a detailed, itemized bill rather than accepting a summary invoice, as over