Blood test, clotting time (PTT)
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $6
- Cash Discount Price: $44
- 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 |
|---|---|---|
| United Mine Workers Of America | $6 | 100% |
| Blue Cross Blue Shield | $6 | 100% |
| UnitedHealthcare | $6 - $7 | 100% |
| Humana | $6 | 100% |
| Aetna | $6 - $8 | 100% |
| Providrs Care Network | $6 | 100% |
| Lantern Specialty Care | $10 | 166% |
Consumer Guidance & Cost Commentary
This blood test for clotting time (PTT) at Kansas Spine & Specialty Hospital, Llc, in Wichita, KS, has a cash median price of $44.00, which is lower than the facility's negotiated rates of $6.00 and the Medicare benchmark of $6.01. While the facility is an Acute Care Hospital owned by a Physician, patients with high-deductible plans might find paying the cash price directly more affordable than using insurance, as commercial negotiated rates often exceed cash prices due to administrative costs and contract structures. If you are self-paying, it is advisable to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final amount owed.
For patients relying on insurance, the data shows that UnitedHealthcare covers this service across three plans, while United Mine Workers Of America and Blue Cross Blue Shield each have one plan covering it. However, because the facility is an in-network location, the No Surprises Act protects you from balance billing for emergency care or non-emergency services from out-of-network providers at this hospital. If you receive a bill for the difference between the provider's chargemaster rate and your insurance allowed amount, you should dispute the charge in writing rather than paying immediately, and request a formal itemized audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors.