Blood test, clotting time (PTT)
Facility: Rawlins County Health Center
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $37
- Cash Discount Price: $45
- vs. Medicare Baseline: 6.16x 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 616% of the Medicare baseline (a markup of 516%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $23 | 383% |
| UnitedHealthcare | $37 - $57 | 616% |
Consumer Guidance & Cost Commentary
For the CPT code 85730, representing a blood test for clotting time (PTT), the Rawlins County Health Center in Atwood, KS, lists a cash median price of $45.00. This cash rate is notably lower than the facility's negotiated rates, which range from $37.00 to $57.00 depending on the insurance plan, and sits below the gross chargemaster price of $54.00. While the facility is a Critical Access Hospital owned by a voluntary non-profit, patients should be aware that insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. If you have a high-deductible plan or have not yet met your deductible, paying the cash price of $45.00 upfront could result in immediate savings compared to having your insurance pay a negotiated amount that you may still owe.
To ensure you are not overcharged, it is important to distinguish between the facility's gross charges and the actual amounts paid by insurers. The data indicates a 6.2% variance compared to Medicare rates, which serve as a benchmark for the true cost of care rather than the inflated list prices hospitals often display. If you receive a bill that includes charges for services not rendered or items that were cancelled, you have the right to request a detailed, itemized audit to identify errors such as unbundled codes or duplicate billing. Furthermore, if you are an out-of-network patient or encounter unexpected charges, the No Surprises Act may protect you from balance billing for emergency care or non-emergency services at in-network facilities, so you should verify the network status of every provider involved before signing any consent waivers.