Blood test, clotting time (PTT)
Facility: Osborne County Memorial Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $64
- Cash Discount Price: $60
- 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 |
|---|---|---|
| UnitedHealthcare | $53 | 882% |
| Health Partners Of Kansas | $60 | 998% |
| Wppa | $67 | 1115% |
| Blue Cross Blue Shield | $69 | 1148% |
Consumer Guidance & Cost Commentary
For the blood clotting time test (CPT 85730) at Osborne County Memorial Hospital in Osborne, KS, the facility's cash median price is $60.00, which is notably lower than the negotiated rates paid by major payers such as UnitedHealthcare ($53) and Health Partners Of Kansas ($60). This price difference highlights a common billing dynamic where paying cash upfront can be more cost-effective than using insurance, particularly for patients with high deductibles. While the facility is a Critical Access Hospital with government-local ownership, patients should proactively ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final bill by bypassing administrative claim processing fees.
When comparing this service to federal benchmarks, the Medicare amount for this procedure is $6.01, indicating that the facility's cash rate of $60.00 represents a significant markup relative to the government's cost-based standard. Although the facility's negotiated rates are higher than the cash price, they remain within the typical range where commercial rates exceed Medicare benchmarks due to administrative costs and contract structures. Consumers are advised to review their specific plan details to understand their out-of-pocket responsibilities, as the negotiated rates listed here represent the maximum amounts insurers agree to pay, which may differ from the actual amount your specific plan covers after deductibles and co-pays are applied.