Blood test, clotting time (PT/INR)
Facility: Ann & Robert H Lurie Childrens Hospital of Chicago
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $104
- Cash Discount Price: $91
- vs. Medicare Baseline: 24.24x 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 $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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 2424% of the Medicare baseline (a markup of 2324%). 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 |
|---|---|---|
| Medicare (plans) | $22 - $2,656 | 513% |
| Mercycare Health | $48 | 1119% |
| Cigna | $55 - $92 | 1282% |
| Blue Cross Blue Shield | $56 - $104 | 1305% |
| La Rabida Childrens Hospital | $65 | 1515% |
| Beacon Health Options | $65 | 1515% |
| Aetna | $65 - $102 | 1515% |
| Centegra | $78 | 1818% |
| Independent Physicians at Mercy | $78 | 1818% |
| UnitedHealthcare | $84 - $92 | 1958% |
| Methodist First Choice | $91 | 2121% |
| Ui Health | $91 | 2121% |
| Northwest Community Healthcare | $91 | 2121% |
| Imagine Health | $91 | 2121% |
| Health Plus | $91 | 2121% |
| Advanced Physicians Association IPA | $91 | 2121% |
| St. Francis | $91 | 2121% |
| Presence Health Partners | $91 | 2121% |
| West Suburban Health Providers | $91 | 2121% |
| Swedish Covenant Physician Partners | $98 | 2284% |
| Shriners Hospital | $98 | 2284% |
| Macneal Health | $104 | 2424% |
| Health Alliance | $104 | 2424% |
| American Psych Systems | $104 | 2424% |
| Magellan | $104 - $900 | 2424% |
| Healthlink Inc. | $107 | 2494% |
| Hfn Inc | $110 - $117 | 2564% |
| Humana | $110 | 2564% |
| Principal Healthcare | $110 | 2564% |
| St. Elizabeth | $110 | 2564% |
| Cofinity | $110 | 2564% |
| Healthstar | $114 | 2657% |
| Sagamore Health Network | $114 | 2657% |
| First Health | $114 | 2657% |
| Preferred Health Network | $114 | 2657% |
| Private Health Care System | $117 | 2727% |
| Benchmark Health | $117 | 2727% |
| Security Health Plan | $117 | 2727% |
| Beech Street | $117 | 2727% |
| Swedish American | $117 | 2727% |
| Employer's Coalition on Health | $117 | 2727% |
| Wellmark/Healthnetwork | $120 | 2797% |
| Health Smart | $124 | 2890% |
| National Provider Network | $124 | 2890% |
| Wea Insurance Group | $124 | 2890% |
| Multiplan | $124 | 2890% |
| Integrated Health Plan | $124 | 2890% |
| Unicare | $3,678 - $8,500 | 85734% |