Blood test, clotting time (PTT)
Facility: Cheyenne County Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $26
- Cash Discount Price: $30
- vs. Medicare Baseline: 4.33x 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 433% of the Medicare baseline (a markup of 333%). 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 |
|---|---|---|
| UnitedHealthcare | $2 - $33 | 33% |
| First Health - All Plans | $19 - $23 | 316% |
| Choice Care - All Plans | $19 - $24 | 316% |
| Aetna | $19 - $32 | 316% |
| Healthy Blue Mcr Adv | $19 - $24 | 316% |
| Tricare | $19 - $24 | 316% |
| Firstguard - All Plans | $21 - $27 | 349% |
| Blue Cross Blue Shield | $22 | 366% |
| Wppa - All Plans | $24 - $30 | 399% |
| Preferred Hc - All Plans | $25 - $32 | 416% |
| Cpm - All Plans | $25 - $32 | 416% |
| Midlands Choice - All Plans | $26 - $32 | 433% |
| Health Partners - All Plans | $26 - $33 | 433% |
| Ppo Next - All Plans | $26 - $33 | 433% |
| Unicare - All Plans | $26 - $33 | 433% |
| Integrated Hp - All Plans | $26 - $33 | 433% |
| Childrens Mercy - All Plans | $27 - $33 | 449% |
| Healthy Blue Mcaid - All Other Plans | $27 - $33 | 449% |
| Healthwave Mcaid - All Plans | $27 - $33 | 449% |
| Providers Care-All Plans | $40 - $50 | 666% |
Consumer Guidance & Cost Commentary
For this blood clotting time test (CPT 85730) at Cheyenne County Hospital, the cash price is $30.00, which matches the facility's median negotiated rate of $26.00 and the state average. While many commercial payers have negotiated rates ranging from $19.00 to $33.00, the cash price remains competitive compared to the broader market. Patients with high-deductible plans may find paying the cash price directly more cost-effective than using insurance, as the negotiated rates for some plans exceed the cash amount. To maximize savings, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%.
When comparing this service to federal benchmarks, the Medicare amount for this procedure is $6.01, which is significantly lower than both the cash price and the median negotiated rate. This highlights that commercial rates often include administrative costs and profit margins that are not reflected in the government's fixed reimbursement. If you receive a bill from an out-of-network provider or for services not covered by your plan, you may face balance billing for the difference between the allowed amount and the full charge. However, under the No Surprises Act, you are protected from balance billing for emergency care and non-emergency services at in-network facilities. Always request a detailed, itemized bill to verify that no services were unbundled or double-charged, as over 80% of hospital bills contain errors that can be corrected through a formal written audit.