Blood test, clotting time (PT/INR)
Facility: Hillcrest Medical Center
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $711
- Cash Discount Price: $376
- vs. Medicare Baseline: 165.73x 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 16573% of the Medicare baseline (a markup of 16473%). 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 |
|---|---|---|
| Healthcare Highways [2210] | $313 - $483 | 7296% |
| Hooray Health [8000] | $313 | 7296% |
| Lucent Health [6000] | $313 | 7296% |
| Oncology Patient Assistance Programs [2295] | $313 | 7296% |
| Black Lung [6055] | $313 | 7296% |
| Oscar Insurance Company [7005] | $313 | 7296% |
| Osma Health Network [2345] | $313 | 7296% |
| UnitedHealthcare | $398 | 9277% |
| Healthscope Benefits [2290] | $398 | 9277% |
| Web Tpa [2115] | $483 | 11259% |
| Resource One Administrators [2815] | $483 | 11259% |
| The Kempton Group Administrators [2905] | $563 | 13124% |
| Pba [1775] | $650 | 15152% |
| National Association of Letter Carriers [1695] | $650 | 15152% |
| Medica [2910] | $711 | 16573% |
| Multiplan [1680] | $711 - $1,077 | 16573% |
| Employee Benefit Management Services [2445] | $914 | 21305% |
| PHCS [1780] | $914 - $1,077 | 21305% |
| Universal Fidelity [2085] | $1,077 | 25105% |
| Hometown Health [2155] | $1,077 | 25105% |
| Pan American Life Insurance Co [1770] | $1,077 | 25105% |
| Planned Administrators Inc [2360] | $1,077 | 25105% |
| Administrative Concepts [1005] | $1,077 | 25105% |
| New Era Life Insurance Company [1705] | $1,077 | 25105% |
| Allied Benefit Systems Inc [1030] | $1,077 | 25105% |
| Mutual of Omaha [1685] | $1,077 | 25105% |
| Mayo Clinic Health Solutions [2280] | $1,077 | 25105% |
| Healthfirst [2395] | $1,077 | 25105% |
| Healthcost Solutions [2415] | $1,077 | 25105% |
| Allied National Global Care [1035] | $1,077 | 25105% |
| Trustmark [2030] | $1,077 | 25105% |
| Pending Ssi [1616] | $1,252 | 29184% |