Blood test, clotting time (PTT)
Facility: Republic County Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $64
- Cash Discount Price: $54
- vs. Medicare Baseline: 10.65x 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 1065% of the Medicare baseline (a markup of 965%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $42 - $81 | 699% |
| Meritain-All Plans | $44 - $86 | 732% |
| Aetna | $44 - $86 | 732% |
| UnitedHealthcare | $45 - $87 | 749% |
| Midlands Choice-All Plans | $47 - $90 | 782% |
| First Health-All Plans | $47 - $90 | 782% |
| Cigna | $47 - $90 | 782% |
Consumer Guidance & Cost Commentary
For the CPT code 85730, representing a blood test for clotting time (PTT), Republic County Hospital in Belleville, KS, lists a cash median price of $54.00 and a median negotiated rate of $64.00. While the facility's cash price is lower than its negotiated rate, it is important to note that commercial insurance contracts often result in higher out-of-pocket costs for patients with high deductibles, as the negotiated ceiling can exceed the cash price. The facility, a Critical Access Hospital owned by a voluntary non-profit, operates in zip code 66935. Patients should verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final amount owed.
The pricing for this service is benchmarked against federal standards, with the Medicare amount set at $6.01. The facility's cash median of $54.00 is notably higher than the Medicare rate, reflecting the standard markup inherent in commercial billing structures where negotiated rates often average 200% to 300% of Medicare amounts. While the provided data includes a "vs_medicare" metric of 10.6, this figure likely represents a specific variance calculation rather than a direct percentage markup of the cash price. Regardless of the specific comparison metric, the data confirms that the facility's cash rate is substantially above the federal baseline. Consumers are advised to request an itemized bill to ensure no unbundled charges or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.