Blood test, clotting time (PTT)
Facility: Kingman Healthcare Center
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $24
- Cash Discount Price: $29
- vs. Medicare Baseline: 3.99x 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 399% of the Medicare baseline (a markup of 299%). 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 |
|---|---|---|
| Celtic Insurance Company | $1 - $26 | 17% |
| Humana | $1 - $24 | 17% |
| Ambetter / Centene | $1 - $26 | 17% |
| Medicaid / KanCare | $1 - $26 | 17% |
| Wellcare | $1 - $24 | 17% |
| UnitedHealthcare | $1 - $54 | 17% |
| Cigna | $3 - $54 | 50% |
| Health Partners | $3 - $54 | 50% |
| Aetna | $3 - $54 | 50% |
| Healthy Blue | $5 | 83% |
| Triwest | $6 | 100% |
Consumer Guidance & Cost Commentary
For this blood clotting time test at Kingman Healthcare Center, the facility's cash price of $29.00 is significantly lower than the gross charge of $58.00. While the negotiated rates for commercial payers like UnitedHealthcare and Cigna range from $1 to $54, the cash price remains the most transparent benchmark for patients. It is important to note that commercial negotiated rates often include administrative overhead and contract premiums, which can make them higher than the cash price even for in-network members. If you have a high-deductible plan, paying the cash price upfront may result in immediate savings compared to having your insurance negotiate a rate that could exceed $29.00, especially given that the facility's cash rate is well below the typical state average for this service.
To ensure you receive the best possible price, we recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the bill by 20% to 50% if paid in full prior to discharge. Additionally, since the facility is a Critical Access Hospital in Kansas, you should verify your specific plan's allowed amount before scheduling, as some in-network contracts may still result in higher out-of-pocket costs than the cash rate. Finally, if you receive a bill after using insurance, request a detailed itemized statement to review every code and ensure no errors or unbundled charges are included, as over 80% of hospital bills contain discrepancies that can be resolved through a formal audit.