Blood test, clotting time (PTT)
Facility: Kansas Medical Center Llc
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $6
- Cash Discount Price: $28
- 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 | $2 | 33% |
| Indian Health | $5 | 83% |
| Medicaid / KanCare | $5 | 83% |
| Medadv_Wellcare | $6 | 100% |
| Blue Cross Blue Shield | $6 - $14 | 100% |
| Ambetter / Centene | $6 | 100% |
| Humana | $6 | 100% |
| Three_Rivers | $12 | 200% |
| Wppa | $17 - $21 | 283% |
| Aetna | $19 | 316% |
Consumer Guidance & Cost Commentary
For CPT code 85730, a blood test for clotting time, Kansas Medical Center Llc in Andover, KS, lists a gross charge of $47.00. The facility's cash median rate is $28.00, which is lower than the negotiated rates paid by most insurance plans, ranging from $6.01 (Medicare) to $41.00 (median paid). While the facility's negotiated rate of $6.00 is slightly below the Medicare benchmark of $6.01, patients should be aware that commercial insurance contracts often include administrative overhead that inflates the baseline price by 20% to 40%. If you have a high-deductible plan, paying the cash price of $28.00 upfront might be more cost-effective than relying on insurance, especially if your deductible has not yet been met. It is always advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
This service is categorized under Acute Care Hospitals in Kansas, and while specific county or state average comparisons were not provided in the data, the facility's pricing structure highlights the importance of comparing rates against the Medicare benchmark rather than the inflated chargemaster list. Medicare rates serve as a scientifically validated cost baseline, representing the true cost of delivery, whereas commercial rates can vary significantly based on network tiering and contract dynamics. To ensure you are receiving fair pricing, we recommend requesting an itemized billing audit to verify that all charges are accurate and that no services were unbundled or double-billed. Always confirm your deductible status and insurance network coverage before scheduling to avoid unexpected