Blood test, clotting time (PTT)
Facility: Hodgeman County Health Center
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $58
- Cash Discount Price: $66
- vs. Medicare Baseline: 9.65x 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 965% of the Medicare baseline (a markup of 865%). 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 - $23 | 349% |
| UnitedHealthcare | $53 - $79 | 882% |
| Triwest - All Plans | $53 | 882% |
| Humana | $53 | 882% |
| Medicaid / KanCare | $53 - $83 | 882% |
| Aetna | $66 | 1098% |
| First Health - All Plans | $75 | 1248% |
| Wppa (Provdrscare) - All Plans | $79 | 1314% |
| Health Partners - All Plans | $79 | 1314% |
Consumer Guidance & Cost Commentary
For the CPT code 85730, representing a blood test for clotting time (PTT), Hodgeman County Health Center in Jetmore, Kansas, has a gross charge of $83.00. The facility's cash median rate is $66.00, which is lower than the negotiated rates paid by most major insurers, including Blue Cross Blue Shield ($21–$23), UnitedHealthcare ($53–$79), and Medicaid/KanCare ($53–$83). While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance contracts often result in higher allowable amounts than self-pay options. If you have a high-deductible plan, paying the cash price of $66.00 upfront might be more cost-effective than your insurance paying a negotiated rate that exceeds this amount, especially if your deductible has not yet been met.
To ensure you are not overcharged, it is advisable to request a prompt-pay discount before scheduling your visit, as hospitals often offer significant reductions for upfront payments to bypass administrative billing cycles. Additionally, if you receive a bill from an out-of-network provider or encounter unexpected charges, you have protections under the No Surprises Act which may prevent balance billing for emergency services or non-emergency services at in-network facilities. Before finalizing any payment, always demand a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Comparing these specific rates to the broader market context, the facility's cash price remains competitive, but verifying your specific plan's allowed amount and asking for self-pay