Blood test, clotting time (PTT)
Facility: Regional Medical Center
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $870
- Cash Discount Price: $38
- vs. Medicare Baseline: 144.76x 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 14476% of the Medicare baseline (a markup of 14376%). 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 |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 14476% |
Consumer Guidance & Cost Commentary
Regional Medical Center, located at 709 W Main Street in Manchester, Iowa, offers a CPT code 85730 for a blood test measuring clotting time (PTT). The facility's cash median rate is $38, which is notably lower than the state average of $48. For patients with high-deductible plans, paying cash upfront can be more cost-effective than using insurance, as the commercial negotiated rate for Medical Associates Health Plan - Tri is significantly higher at $870. Patients are encouraged to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which often reduce the final bill by 20% to 50% when paid in full before or shortly after the service.
This pricing data is based on a single payer and reflects rates from the 2026-06 vintage. While the facility's cash rate of $38 is lower than the state average, it is important to note that the Medicare benchmarking amount for this service is only $6.01. The substantial difference between the cash rate and the Medicare amount highlights the cost structure of the facility, which is a government-owned Critical Access Hospital. Consumers should verify their specific plan details and deductibles before scheduling, as the $870 negotiated rate may only apply if the patient's deductible has been met. Always request an itemized bill if you choose to pay with insurance to ensure there are no unexpected charges or balance billing issues.