CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Lafayette Regional Health Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $147
  • Cash Discount Price: $341
  • vs. Medicare Baseline: 24.46x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Lafayette Regional Health Center is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $341. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 24.46x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$341

Average discount available for prompt cash payment at this facility.

Insurance Median
$147

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.01

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.01 (100%)
Cash / Self-Pay: $341 (5674%)
Insurance Median: $147 (2446%)
Cash: $341 (5674% of Medicare)
Ins. Median: $147 (2446% of 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 2446% of the Medicare baseline (a markup of 2346%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $5 - $299 83%
Amerigroup $5 83%
Healthyblue $5 83%
Home State Health Plan $5 83%
Medicaid / KanCare $5 83%
Unicare $5 83%
United $5 - $154 83%
Corvel Corporation $13 - $290 216%
Oha Network $13 - $171 216%
Ambetter / Centene $64 1065%
Nhc Advantage $65 1082%
Universal Healthcare $89 1481%
Humana $115 - $147 1913%
Blue Cross Blue Shield $130 - $341 2163%
College Park Family Care Center $147 2446%
Oscar $171 2845%
Cigna $195 - $244 3245%
Wppa Providrs Care Network $256 4260%
Multiplan $266 4426%
Coventry $272 4526%
Coventry Kc Mo $272 4526%
Cco, Inc. $290 4825%
Focus Healthcare Mgmt, Inc $307 5108%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals