Blood test, clotting time (PTT)
Facility: Goodland Regional Medical Center
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $53
- Cash Discount Price: $53
- vs. Medicare Baseline: 8.82x 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 882% of the Medicare baseline (a markup of 782%). 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 | $23 | 383% |
| Wppa | $50 - $53 | 832% |
| UnitedHealthcare | $53 | 882% |
Consumer Guidance & Cost Commentary
For the blood clotting time test (CPT 85730) at Goodland Regional Medical Center in Goodland, Kansas, the facility's cash median price is $53.00, which is lower than the gross charge of $59.00. While the facility is a Critical Access Hospital owned by the local government, the negotiated rates for commercial payers such as Blue Cross Blue Shield, Wppa, and UnitedHealthcare range from $23.00 to $53.00, depending on the specific plan. It is important to note that commercial negotiated rates often include administrative overhead and can sometimes exceed the cash price; therefore, patients with high-deductible plans who have not yet met their out-of-pocket maximum may find paying the $53.00 cash rate directly more cost-effective than relying on insurance, which could result in higher allowed amounts before the deductible is satisfied.
When evaluating the cost against federal benchmarks, the Medicare amount for this service is $6.01, and the facility's cash rate of $53.00 represents a significant markup relative to this baseline. The data indicates a comparison metric of 8.8 against Medicare, highlighting the substantial difference between the government's fixed reimbursement rate and the facility's pricing structure. To ensure you are receiving the best possible price, we recommend requesting a formal itemized billing audit to verify that no unbundled codes or services not rendered have inflated the total. Additionally, before scheduling, please explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, as these upfront payment incentives can further reduce the final amount owed.