Blood test, clotting time (PTT)
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $113
- Cash Discount Price: $151
- vs. Medicare Baseline: 18.80x 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 1880% of the Medicare baseline (a markup of 1780%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $91 | 1514% |
| Americas Choice Provider Network | $106 | 1764% |
| Usa Managed Care Organization | $113 | 1880% |
| Quiktrip Corporation | $113 | 1880% |
| Provider Network Of America | $113 | 1880% |
| Velocity | $113 | 1880% |
| Multiplan-Phcs | $121 | 2013% |
| Prime Health Services | $128 | 2130% |
| Medincrease | $136 | 2263% |
Consumer Guidance & Cost Commentary
For the CPT code 85730, representing a blood test for clotting time (PTT), the Rehabilitation Hospital Of Overland Park lists a cash price of $151.00. This cash rate is notably higher than the national average for this service, which is $6.01. While commercial insurance plans typically negotiate lower rates than the cash price, the data shows a median negotiated rate of $113.00 across nine payers, with individual negotiated amounts ranging from $91.00 to $136.00. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the full cash price of $151.00 upfront may be more cost-effective than having insurance process the claim, as the insurer's allowed amount could exceed the cash rate.
It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still verify their specific plan details before scheduling. If you choose to pay directly, ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if settled within 30 days. Additionally, if you receive a summary bill, request a full itemized statement to ensure no errors, unbundled codes, or charges for services not rendered are included, as over 80% of hospital bills contain discrepancies that can be corrected through a formal written audit.