Blood test, clotting time (PTT)
Facility: Kearny County Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $67
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 11.15x 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 1115% of the Medicare baseline (a markup of 1015%). 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 |
|---|---|---|
| Humana | $67 | 1115% |
| UnitedHealthcare | $67 | 1115% |
| Blue Cross Blue Shield | $67 | 1115% |
| Wps Gha - Mac J5 Part A | $67 | 1115% |
| Community Care Health Plan Of | $67 | 1115% |
| Aetna | $67 | 1115% |
Consumer Guidance & Cost Commentary
For the CPT code 85730, representing a blood test for clotting time (PTT), the facility in Lakin, Kansas, has a negotiated rate of $67.00 across all six commercial payers, including Humana, UnitedHealthcare, and Blue Cross Blue Shield. This rate is significantly higher than the Medicare benchmark of $6.01, reflecting the typical administrative markup and contract structures that commercial insurers use. While the facility is a Critical Access Hospital owned by the local government, the negotiated amount does not align with the state or county averages provided in this dataset, as the specific regional comparison figures were not included in the available data. Patients should be aware that while in-network rates protect against balance billing, they may still exceed the actual cost of care when compared to federal benchmarks.
Given the substantial difference between the negotiated rate and the cash median, which is not listed for this service, patients with high-deductible plans might find it beneficial to inquire about self-pay or prompt-pay discounts directly with the hospital. These discounts can offer immediate liquidity incentives that bypass the administrative overhead of insurance claims processing, potentially resulting in a lower out-of-pocket cost than the standard negotiated fee. It is important to request a waiver of insurance submission before scheduling to ensure the cash rate applies, and to always review the itemized bill for any unbundled codes or services not rendered. Since the cash price is not disclosed in the current data, the most effective step for a patient is to contact the billing department at Kearny County Hospital to confirm if a self-pay classification is available for this specific procedure.