Blood test, clotting time (PTT)
Facility: Stanton County Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $83
- Cash Discount Price: $67
- vs. Medicare Baseline: 13.81x 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 1381% of the Medicare baseline (a markup of 1281%). 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 | $21 - $230 | 349% |
| Healthy Blue Mcr Adv - All Other Plans | $82 - $238 | 1364% |
| Healthy Blue Mcaid | $84 - $207 | 1398% |
Consumer Guidance & Cost Commentary
For this blood clotting time test at Stanton County Hospital in Johnson, KS, the cash price is $67.00, which matches the facility's median paid amount. This cash rate is notably higher than the state average for this procedure, as indicated by the 13.8% variance compared to Medicare benchmarks. While commercial insurance plans like Blue Cross Blue Shield and Healthy Blue have negotiated rates ranging from $82 to $238, these figures often exceed the cash price due to administrative costs and contract structures. Patients with high-deductible plans or those who have already met their out-of-pocket limits may find paying the $67.00 cash rate directly more cost-effective than relying on insurance, which could result in higher allowed amounts before deductibles are satisfied.
Before scheduling, it is crucial to verify whether the hospital offers "self-pay" or "prompt-pay" discounts, as these can significantly reduce the final bill. Although the facility is a Critical Access Hospital owned by the local government, patients should request a waiver of insurance submission if they choose to pay cash upfront to avoid automatic claims processing that might void a cash agreement. Additionally, since over 80% of hospital bills contain errors, consumers should always demand a full itemized statement rather than accepting a summary bill, ensuring no unbundled codes or services not rendered are included. By comparing the negotiated rates against the Medicare baseline and actively requesting discounts, patients can better understand the true cost of care and avoid unexpected balance billing.