Blood test, clotting time (PTT)
Facility: Norton County Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $32
- Cash Discount Price: $60
- vs. Medicare Baseline: 5.32x 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 532% of the Medicare baseline (a markup of 432%). 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 | $32 | 532% |
Consumer Guidance & Cost Commentary
For the CPT code 85730 (Blood test, clotting time (PTT)), Norton County Hospital in Norton, KS, lists a cash median price of $60.00, which is significantly lower than the facility's negotiated rate of $32.00 and the state average of $86.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates can sometimes exceed cash prices due to administrative overhead and contract dynamics. If you have a high-deductible plan, paying the cash price of $60.00 upfront might result in lower out-of-pocket costs compared to your insurance paying the negotiated rate of $32.00, especially if your deductible has not yet been met.
To ensure you are receiving the most accurate and transparent pricing, it is recommended to request an itemized billing audit before finalizing payment, as summary bills often obscure individual line items and potential errors. Additionally, ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final amount owed by 20% to 50% if settled within a short window. Since the Medicare benchmark for this service is $6.01, the facility's cash rate represents a substantial markup above the federal baseline, but comparing this to your specific insurance allowed amount and your county's average will provide the clearest picture of your financial obligation.