Blood test, clotting time (PTT)
Facility: Kiowa County Memorial Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $51
- Cash Discount Price: $48
- vs. Medicare Baseline: 8.49x 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 849% of the Medicare baseline (a markup of 749%). 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 - $51 | 383% |
| UnitedHealthcare | $46 - $57 | 765% |
| Health Partners Of Ks-All Plans | $50 | 832% |
| Medica Prime Mcare Cost-All Plans | $51 | 849% |
| Celtic Comml Exchange-All Other Plans | $51 | 849% |
| Aetna | $51 | 849% |
| Humana | $51 | 849% |
| Medicaid / KanCare | $57 | 948% |
| Providrs Care/Wppa-All Plans | $86 | 1431% |
Consumer Guidance & Cost Commentary
For this blood clotting time test (CPT 85730) at Kiowa County Memorial Hospital in Greensburg, KS, the facility's cash median price is $48.00, which is lower than the state average of $57.00. While many insurance plans negotiate rates ranging from $46 to $86, patients with high-deductible plans might find paying the cash price directly more cost-effective if their insurance allowed amount exceeds $48.00. It is important to note that commercial negotiated rates often include administrative overhead and can be significantly higher than the cash price, so verifying your specific plan's allowed amount before scheduling is essential to avoid unexpected costs.
Although the facility is a Critical Access Hospital owned by the local government, patients should proactively ask about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront. If you receive a bill from an out-of-network provider or for services not rendered, you have the right to request an itemized audit to identify errors or unbundled charges, as over 80% of hospital bills contain mistakes. Additionally, under the No Surprises Act, you are protected from balance billing for emergency care or non-emergency services from out-of-network providers at in-network facilities, so do not feel pressured to sign away your rights to dispute any surprise charges immediately.