Blood test, clotting time (PTT)
Facility: Morris County Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $48
- Cash Discount Price: $74
- vs. Medicare Baseline: 7.99x 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 799% of the Medicare baseline (a markup of 699%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $6 | 100% |
| Va Ccn-All Plans | $7 | 116% |
| Aetna | $16 | 266% |
| Blue Cross Blue Shield | $21 - $48 | 349% |
| UnitedHealthcare | $48 - $123 | 799% |
| Choice Care Mcr Adv-All Plans | $48 | 799% |
| Coventry Mcr | $48 | 799% |
| Cigna | $89 | 1481% |
| Multiplan-All Plans | $111 | 1847% |
| Coventry Comm-All Other Plans | $111 | 1847% |
Consumer Guidance & Cost Commentary
For this blood clotting time test at Morris County Hospital in Council Grove, Kansas, the facility's cash price of $74.00 is notably higher than the state average of $68.00. While the hospital is a Critical Access Hospital owned by the local government, patients should be aware that paying cash upfront can sometimes be more cost-effective than using insurance if their plan's negotiated rate exceeds the cash price. The facility offers a prompt-pay discount for those who settle the bill immediately, which can further reduce the final amount owed.
Commercial insurance rates vary significantly across payers, with negotiated amounts ranging from $6 to $111 depending on the plan. Notably, the median negotiated rate of $48.00 is lower than the cash price, suggesting that for many insured patients, using their coverage will result in a lower out-of-pocket cost. However, because this is a Critical Access Hospital, patients should verify their specific plan's allowed amount before scheduling to avoid balance billing, especially if they are out-of-network. It is also advisable to request an itemized bill to ensure no unbundled charges or services not rendered are included in the final invoice.