Blood test, clotting time (PTT)
Facility: Wichita County Health Center
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $33
- Cash Discount Price: $29
- vs. Medicare Baseline: 5.49x 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 549% of the Medicare baseline (a markup of 449%). 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 |
|---|---|---|
| Medicaid / KanCare | $30 | 499% |
| UnitedHealthcare | $36 | 599% |
Consumer Guidance & Cost Commentary
For the blood clotting time test (CPT 85730) at Wichita County Health Center in Leoti, Kansas, the facility's cash price of $29.00 is lower than the state average, which sits at $36.00. While Medicaid / KanCare members can expect a payment of $30.00 and UnitedHealthcare members a payment of $36.00, patients with high-deductible plans may find paying cash upfront is the most cost-effective option. This is because the cash price is already below the negotiated rates paid by major insurers, meaning using insurance would likely result in a higher out-of-pocket expense once deductibles are met.
To maximize savings, patients should explicitly ask the billing department about "prompt-pay" discounts before scheduling the visit, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is also important to request a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors that can be corrected. Finally, since this facility is in-network for the listed payers, the No Surprises Act protects patients from unexpected balance billing for emergency services or out-of-network ancillary providers, ensuring that the negotiated rates remain the final amount owed.