CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Riverside Community Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $607
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Riverside Community Hospital is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $607. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.
Cash / Self-Pay
$607

Average discount available for prompt cash payment at this facility.

Insurance Median
$5

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: $607 (14149%)
Insurance Median: $5 (117%)
Cash: $607 (14149% of Medicare)
Ins. Median: $5 (117% 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Bristol Hospice $3 70%
Aetna $4 - $109 93%
Alignment Health Plan $4 93%
Blue Cross Blue Shield $4 - $22 93%
Blue Shield $4 - $43 93%
Brand New Day $4 - $5 93%
Care1St Health Plan $4 93%
Central Health Plan $4 93%
Clever Care Of Golden State $4 93%
Easy Choice Health Plan $4 93%
Heritage Provider Network $4 - $6 93%
Humana $4 93%
Redlands Community Hospital $4 93%
Riverside Medical Clinic $4 - $5 93%
Riverside Physician $4 93%
Scan Health Plan $4 93%
Triwest Healthcare Alliance $4 93%
United $4 - $160 93%
UnitedHealthcare $4 93%
Corvel Corporation $5 117%
Health Net $5 - $135 117%
Healthsmart $5 - $485 117%
La Care Health $5 117%
Molina $5 117%
Next $5 - $485 117%
Inland Empire Health Plan $7 163%
Bright Health $11 256%
Cigna $12 280%
Medcare Partners $91 2121%
First Health $267 - $546 6224%
American Health System $273 6364%
Multiplan $485 - $516 11305%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4445 Magnolia Avenue, Riverside, CA 92501
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals