Blood test, clotting time (PTT)
Facility: Scott County Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $71
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 11.81x 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 1181% of the Medicare baseline (a markup of 1081%). 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 | $5 - $75 | 83% |
| Blue Cross Blue Shield | $23 | 383% |
| Humana | $33 | 549% |
| Wppa | $47 - $1,200 | 782% |
| Aetna | $71 | 1181% |
Consumer Guidance & Cost Commentary
For the CPT code 85730, representing a blood test for clotting time, Scott County Hospital in Scott City, KS, has a gross charge of $79.00. This amount is significantly higher than the state average, which is $6.01, and exceeds the Medicare benchmark of $6.01 by 11.8%. While the facility offers a median negotiated rate of $71.00 for in-network commercial payers, this rate remains well above the Medicare baseline. Patients with high-deductible plans should be aware that paying the cash price directly might result in lower out-of-pocket costs if their insurance negotiated rate exceeds the cash price, though the data indicates the cash median is not currently available for this service.
It is important to verify your specific plan's allowed amount before scheduling, as in-network rates can vary widely between different insurance carriers. For instance, while UnitedHealthcare, Blue Cross Blue Shield, and Humana have fixed negotiated rates ranging from $23 to $75, WPPA has a much wider range of $47 to $1,200 across its two plans. To potentially reduce costs, patients should ask the billing department about "self-pay" or "prompt-pay" discounts, which can offer fee reductions of 20% to 50% for upfront payment. Additionally, since over 80% of hospital bills often contain errors, requesting a detailed, itemized statement before paying is a critical step to ensure accuracy and avoid unexpected charges.