Blood test, clotting time (PTT)
Facility: Rooks County Health Center
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $54
- Cash Discount Price: $57
- vs. Medicare Baseline: 8.99x 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 899% of the Medicare baseline (a markup of 799%). 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 |
|---|---|---|
| Veterans Admin - All Plans | $5 - $36 | 83% |
| Blue Cross Blue Shield | $23 | 383% |
| Tricare | $36 | 599% |
| Celtic Mcr Adv | $36 | 599% |
| Celtic Comm - All Other Plans | $39 | 649% |
| Preferred Benefits Admin | $68 | 1131% |
| UnitedHealthcare | $68 | 1131% |
| Aetna | $68 | 1131% |
| Health Partners - All Plans | $72 | 1198% |
| Preferred Hlthcare - All Other Plans | $72 | 1198% |
| Healthy Blue Mcaid - All Plans | $76 | 1265% |
Consumer Guidance & Cost Commentary
For this blood clotting time test at Rooks County Health Center in Plainville, Kansas, the facility's cash price of $57.00 is significantly lower than the average negotiated rates charged by insurance payers, which range from $5 to $76 depending on the plan. While the facility is a Critical Access Hospital owned by a government hospital district, patients with high-deductible plans may find paying the cash price directly more affordable than relying on insurance, as the negotiated rates for many commercial payers exceed the cash amount. It is important to note that while the facility offers a cash option, patients should verify their specific plan's deductible status before scheduling, as using insurance could result in higher out-of-pocket costs if the deductible has not yet been met.
To ensure you are not overcharged, we recommend requesting a full itemized bill that lists every specific CPT code and unit cost, as summary bills often hide errors or unbundled charges. Additionally, if you receive a balance bill for services rendered at this in-network facility, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services from out-of-network providers at in-network hospitals. If you do encounter an unexpected bill, do not pay immediately; instead, contact the billing supervisor in writing to dispute any errors and request an audit to confirm that all charges are accurate and compliant with federal regulations.