Blood test, clotting time (PTT)
Facility: Greeley County Health Services
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $5
- Cash Discount Price: $137
- vs. Medicare Baseline: 0.83x 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.
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 |
|---|---|---|
| Medicaid / KanCare | $5 | 83% |
| Aetna | $5 | 83% |
Consumer Guidance & Cost Commentary
For this blood clotting time test at Greeley County Health Services, the cash price of $137 is significantly lower than the facility's gross charge of $195, offering a potential savings for patients with high-deductible plans or those without insurance. While the facility is a Critical Access Hospital in Tribune, KS, and is owned by the local government, the data does not provide specific county or state average rates for comparison. However, it is important to note that commercial insurance negotiated rates can sometimes exceed cash prices due to administrative overhead; for instance, the median negotiated rate listed is $5.00, which appears to be an outlier or specific plan average, and the Medicare benchmark is $6.01. Patients should verify their specific plan's allowed amount before scheduling, as assuming that being in-network guarantees the lowest price is a common pitfall, as different insurers negotiate different rates.
If you are using insurance, be aware that balance billing is generally prohibited for out-of-network services at in-network facilities under the No Surprises Act, though unexpected ancillary charges can still occur. If you receive a bill that seems too high, request an itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes. Additionally, if you choose to pay cash directly, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if paid upfront, bypassing the costly claims processing cycle that insurance companies utilize. Always ensure you are not signing away your rights to dispute out-of-network charges or accepting summary bills without seeing the detailed line items.