CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Paradise Valley Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $4
  • Cash Discount Price: $4
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Paradise Valley Hospital is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 2400 East 4Th St, National City, CA.
Cash / Self-Pay
$4

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: $4 (93%)
Insurance Median: $4 (93%)
Cash: $4 (93% 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.

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
Aetna $4 - $5 93%
Blue Sheid Of Promise $4 93%
Blue Shield Of Ca, Va $4 93%
Brand New Day $4 - $6 93%
Ca Foundation For Medical Care $4 93%
Central Health $4 93%
Choice Physicians Network $4 93%
Clever Care Of Golden State, Inc $4 93%
Community Health Group $4 - $5 93%
County Of San Diego $4 93%
Golden Physicians Medical Group $4 - $5 93%
Health Excel Ins $4 93%
Health Net Of Ca $4 - $6 93%
Heritage Provider Netwrok $4 - $6 93%
Managed Health Network $4 93%
Medicare (plans) $4 93%
Molina $4 93%
Renal Payer Solutions $4 93%
Traditional Medi-Cal $4 93%
Tricare $4 93%
UnitedHealthcare $4 - $7 93%
Usa Senior Care Network $4 93%
Verda Health Plan $4 93%
Health Net Federal Service (Cdcr) $5 117%
Imperial Health Plan Of Ca $5 117%
Veterans Evaluation Services $5 117%
Ca Dept Of Correction & Rehab $6 140%
Employer Direct Healthcare $6 140%
Integrated Medical Solutions $6 140%
Worker Comp $6 140%
Naphcare $7 - $9 163%
Scripps Health $7 163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 East 4Th St, National City, CA 91950
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals