Blood test, clotting time (PTT)
Facility: Stevens County Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $27
- Cash Discount Price: $70
- vs. Medicare Baseline: 4.49x 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 449% of the Medicare baseline (a markup of 349%). 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 |
|---|---|---|
| Aetna | $4 - $70 | 67% |
| Blue Cross Blue Shield | $21 - $23 | 349% |
| Humana | $26 | 433% |
| First Health - All Plans | $63 | 1048% |
| Wppa - All Plans | $66 | 1098% |
| Medicaid / KanCare | $70 | 1165% |
Consumer Guidance & Cost Commentary
For this blood clotting time test at Stevens County Hospital in Hugoton, Kansas, the cash price is $70.00, which matches the facility's gross chargemaster rate. While the hospital is a Critical Access Hospital owned by the local government, commercial insurance plans in this area typically pay significantly less than the cash price. For example, Aetna plans pay an average of $44.00, and Blue Cross Blue Shield plans pay $21.00 to $23.00. This price transparency data highlights that for patients with high-deductible plans, paying the full cash price of $70.00 upfront might be more cost-effective than relying on insurance, as the negotiated rates paid by insurers are often lower than the cash rate. However, patients should verify their specific plan's deductible status before deciding, as paying out-of-pocket may not be necessary if the insurance has already covered the cost.
Patients should be aware that the $70.00 cash price is not the only option available; the hospital offers a median negotiated rate of $27.00 for in-network members, though this amount is still higher than the cash price. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur if ancillary services like lab tests are billed separately. To avoid these surprises, consumers should request a full itemized bill before paying and dispute any charges that do not match the CPT code for this specific procedure. Additionally, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final amount owed if the bill