Blood test, clotting time (PTT)
Facility: Jewell County Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $42
- Cash Discount Price: $36
- vs. Medicare Baseline: 6.99x 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 699% of the Medicare baseline (a markup of 599%). 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 |
|---|---|---|
| Rural Carriers - All Plans | $29 - $51 | 483% |
| Aetna | $31 - $54 | 516% |
| Meritain - All Plans | $31 - $54 | 516% |
| UnitedHealthcare | $33 - $57 | 549% |
| Midlands Choice - All Plans | $33 - $57 | 549% |
| Cigna | $33 - $57 | 549% |
| First Health - All Plans | $33 - $57 | 549% |
Consumer Guidance & Cost Commentary
For this blood clotting time test (CPT 85730) at Jewell County Hospital in Mankato, KS, the cash price is $36.00, which is lower than the facility's gross charge of $48.00. While the hospital is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative costs and contract structures. In this case, the median negotiated rate across seven payers is $42.00, meaning that paying cash upfront could result in immediate savings of up to $6.00 compared to what an insurance plan might allow. If you have a high-deductible plan, paying the cash price directly may be more cost-effective than waiting for insurance to process a claim that could exceed your out-of-pocket maximum.
To ensure you are receiving the best possible rate, it is recommended to ask the billing department specifically about "self-pay" or "prompt-pay" discounts before scheduling your visit, as these can further reduce the final amount owed. Additionally, if you are using insurance, be cautious of balance billing, which occurs when a provider bills you for the difference between their full charge and what your insurance pays. Fortunately, federal protections like the No Surprises Act generally ban balance billing for emergency care and non-emergency services at in-network facilities. Finally, if you receive a bill, always request a detailed, itemized statement rather than accepting a summary invoice, as this allows you to verify that every charge corresponds to a service actually rendered and helps identify potential errors before payment.