CMS Price Transparency Data
Blood test, clotting time (PT/INR)
Facility: Clovis Community Medical Center
Billing Code: 85610 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85610
- Insurance Median: $4
- Cash Discount Price: $82
- vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Clovis Community Medical Center is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$82
Average discount available for prompt cash payment at this facility.
Insurance Median
$4
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$4.29
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $4.29 (100%)
Cash / Self-Pay: $82 (1911%)
Insurance Median: $4 (93%)
Cash: $82 (1911% of Medicare)
Ins. Median: $4 (93% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $4.29 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medi-Cal Health Plan of San Mateo | $3 | 70% |
| Ccs Kings | $3 | 70% |
| Medi-Cal Molina | $3 | 70% |
| Ccs Kern | $3 | 70% |
| Ccs Fresno | $3 | 70% |
| Ccs Madera/Sacramento | $3 | 70% |
| Medi-Cal La Care Health | $3 | 70% |
| Fresno County Funded Specialty Care | $3 | 70% |
| Medi-Cal Cencal Health | $3 | 70% |
| Ccs Tulare | $3 | 70% |
| Ccs Mariposa | $3 | 70% |
| Generic Care Out of County | $3 | 70% |
| Medi-Cal Contra Costa Health Plan | $3 | 70% |
| Cal Caloptima | $3 | 70% |
| Medi-Cal Community Health Group | $3 | 70% |
| Chdp | $3 | 70% |
| Medi-Cal California Health & Wellness Plan | $3 | 70% |
| Gold Coast Medi-Cal | $3 | 70% |
| Genetically Handicapped Person | $3 | 70% |
| Generic Ccs Other Counties | $3 | 70% |
| Blue Cross Blue Shield | $3 - $57 | 70% |
| San Francisco Health Plan Medi-Cal | $3 | 70% |
| Medi-Cal Blue Shield Promise Health | $3 | 70% |
| Santa Clara Family Health Plan - Valley Health | $3 | 70% |
| Medi-Cal Inland Empire Health | $3 | 70% |
| Ccs Merced | $3 | 70% |
| Santa Clara Family Health Plan - Premier Health | $3 | 70% |
| Medi-Cal Alameda Alliance for Health | $3 | 70% |
| Ccs Stanislaus | $3 | 70% |
| Medi-Cal Kern Family Health | $3 | 70% |
| Blue Shield | $3 - $51 | 70% |
| Medi-Cal Partnership Health Plan of Ca | $3 | 70% |
| Wellcare | $4 | 93% |
| Sante-Healthnet Seniority | $4 | 93% |
| Blue Shield Saint Agnes | $4 | 93% |
| Sante-Blue Shield/Sante | $4 | 93% |
| Victims of Crime | $4 | 93% |
| Gemcare HMO | $4 | 93% |
| Blue Shield Hmo-Cvmp/Medpro | $4 | 93% |
| Sante | $4 - $5 | 93% |
| Meritage Blue Shield 65 Plus | $4 | 93% |
| Railroad Part A | $4 | 93% |
| Generic Bscphp | $4 | 93% |
| Railroad Part B | $4 | 93% |
| Meritage Brand New Day | $4 | 93% |
| Cares Act Provider Relief Fund | $4 | 93% |
| Sante Sub Cap-Blue Shield/Sante | $4 | 93% |
| Care1St HMO - Ehs | $4 | 93% |
| Advantek Table Mountain Rancheria Tribal Member | $4 | 93% |
| Medicare (plans) | $4 | 93% |
| Kaiser | $4 | 93% |
| Sequoia Pace - Peak Tpa | $4 | 93% |
| Blue Shield 65 Plus HMO Ehs | $4 | 93% |
| Blue Shield 65 Plus HMO First Choice | $4 | 93% |
| Healthnet HMO - Sante | $4 | 93% |
| Healthnet Sante | $4 | 93% |
| Blue Shield Sante | $4 | 93% |
| Hartford Life Supplement | $4 | 93% |
| Healthnet Sante Dual Risk | $4 | 93% |
| Bscphp - Dhmso | $4 | 93% |
| Healthnet HMO - La Salle | $4 | 93% |
| Railroad Part A & B | $4 | 93% |
| UnitedHealthcare | $4 - $47 | 93% |
| Bscphp HMO - First Choice | $4 | 93% |
| Bscphp - First Choice | $4 | 93% |
| Us Marshal | $4 | 93% |
| Healthnet HMO - Dhmso | $4 | 93% |
| Healthnet Sante - Sub Cap Dual Risk | $4 | 93% |
| Sante-Sub Cap Ma Brand New Day | $4 | 93% |
| Medi-Cal Innovative Integrated Health | $4 | 93% |
| Todays Pyramid | $4 | 93% |
| Scan Health Plan | $4 | 93% |
| Blue Shield Promise - Imperial | $4 | 93% |
| Generic Victims of Crime | $4 | 93% |
| Meritage Healthnet HMO | $4 | 93% |
| Aetna | $4 - $20 | 93% |
| Healthnet HMO - Cvmp/Medpro | $4 | 93% |
| Brand New Day | $4 | 93% |
| Humana | $4 - $76 | 93% |
| Sante Sub Cap Healthnet Seniority | $4 | 93% |
| Generic | $4 | 93% |
| Cigna | $4 - $56 | 93% |
| Sequoia Pace | $5 | 117% |
| Imperial Health Plan HMO | $5 | 117% |
| Health Plan of San Joaquin | $5 | 117% |
| Champion Health Plan of California Ma | $5 | 117% |
| Alignment Health Plan | $5 | 117% |
| Innovative Integrated Health Community Plans HMO | $5 | 117% |
| Adventist -McL Calviva Sub Cap | $6 | 140% |
| Correctcare Integrated Health | $6 | 140% |
| Healthnet | $7 - $53 | 163% |
| Naphcare Inc-Mendota | $9 | 210% |
| Coalinga State Hospital | $9 | 210% |
| Central Valley Medical Providers | $22 - $63 | 513% |
| Community Care | $23 - $29 | 536% |
| Employer 90/40 | $36 | 839% |
| Central Ca Indian Health | $50 - $63 | 1166% |
| Nx Health Network PPO | $50 | 1166% |
| Healthsmart | $61 - $72 | 1422% |
| Network By Design | $68 | 1585% |
| Coventry Health Care (First Health Network) | $68 | 1585% |
| PHCS | $76 | 1772% |
| Generic Multiplan | $76 | 1772% |
| Well Path (Cfmg) | $99 - $126 | 2308% |