Blood test, clotting time (PTT)
Facility: Lindsborg Community Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $80
- Cash Discount Price: $64
- vs. Medicare Baseline: 13.31x 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 1331% of the Medicare baseline (a markup of 1231%). 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 |
|---|---|---|
| Tricare | $12 - $55 | 200% |
| Coventry Mcr Adv | $12 - $55 | 200% |
| Cigna | $21 - $99 | 349% |
| Coventry Comm-All Other Plans | $22 - $105 | 366% |
| UnitedHealthcare | $22 - $105 | 366% |
| Blue Cross Blue Shield | $22 | 366% |
| Multiplan-All Plans | $23 - $109 | 383% |
| Century Health-All Plans | $23 - $111 | 383% |
| Coventry Wc | $23 - $111 | 383% |
| Health Partners -All Plans | $23 - $111 | 383% |
| Wppa-All Plans | $23 - $111 | 383% |
| Phcs Preferred-All Plans | $23 - $109 | 383% |
Consumer Guidance & Cost Commentary
For the CPT code 85730, representing a blood test for clotting time (PTT), Lindsborg Community Hospital in Kansas has a cash median price of $64.00 and a negotiated median paid amount of $55.00. This facility, a Critical Access Hospital, offers a cash rate that is 13.3% lower than the Medicare benchmark of $6.01, though the gross charge listed is $92.00. While commercial payers negotiate rates ranging from $12 to $111 depending on the plan, the cash price can be a more economical option for patients with high-deductible plans or those without insurance, as the cash rate is often lower than the negotiated amounts insurers pay. Patients should verify their specific plan's allowed amount, as some commercial contracts may exceed the cash price, making out-of-pocket payment the most cost-effective choice.
To ensure you are receiving the most accurate pricing, it is important to request an itemized bill rather than accepting a summary invoice that may obscure individual charges or unbundled components. Since over 80% of hospital bills contain errors, asking for a detailed line-by-line statement helps identify any services not rendered or duplicate charges. Additionally, if you are paying out-of-network or encounter unexpected balances, the No Surprises Act provides protections against balance billing for emergency care and non-emergency services at in-network facilities. Before scheduling, you should explicitly ask the hospital about prompt-pay discounts, which can reduce the total cost by 20% to 50% if settled upfront, and confirm whether your specific insurance plan requires you to meet a deductible before the negotiated rate applies.