Blood test, clotting time (PT/INR)
Facility: San Antonio Regional Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $11
- Cash Discount Price: $185
- vs. Medicare Baseline: 2.56x 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 256% of the Medicare baseline (a markup of 156%). 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 |
|---|---|---|
| Ambetter / Centene | $2 - $82 | 47% |
| Blue Cross Blue Shield | $3 - $243 | 70% |
| Blue Shield Hmo Pos / Calpers Ppo | $3 - $166 | 70% |
| Epic Health Plan - All Other Plans | $3 - $134 | 70% |
| Healthnet Medi-Cal | $3 | 70% |
| Blue Shield Epo Ppo - All Other Plans | $4 - $180 | 93% |
| Blue Shield Mcr Adv | $4 | 93% |
| Caremore Mcr Adv - All Plans | $4 | 93% |
| Choice Phycn Ntwrk Mcr Adv-All Other Plans | $4 | 93% |
| Healthnet Mcr Adv | $4 | 93% |
| Humana | $4 | 93% |
| Iehp Mcr Adv | $4 | 93% |
| Inter Valley Hp Mcr Adv- All Plans | $4 | 93% |
| Kindred Mcr Adv-All Plans | $4 | 93% |
| Molina Mcr Adv | $4 | 93% |
| Pc Inland Valley Scan | $4 - $224 | 93% |
| Pc Inland Valley-All Other Plans | $4 - $224 | 93% |
| Scan Health Plan Mcr Adv-All Plans | $4 | 93% |
| Tricare | $4 | 93% |
| Universal Care - All Plans | $4 | 93% |
| Zelis Mcr Adv | $4 | 93% |
| Alpha Care Mg Mcal/Hlthy Kids | $5 | 117% |
| Choice Phycn Ntwrk Op Only | $5 | 117% |
| Coventry Ccn/First Hlth - All Plans | $5 - $246 | 117% |
| Heritage Prov Ntwrk/Regal Mcal | $5 | 117% |
| Imperial Health Mcr Adv-All Plans | $5 | 117% |
| Kaiser Medi-Cal | $5 | 117% |
| Kasiser Mcr Adv | $5 | 117% |
| Medi-Cal | $5 | 117% |
| Aetna | $6 - $448 | 140% |
| Choicecare Ntwrk-All Plans | $6 - $323 | 140% |
| Iehp Comm - All Other Plans | $6 | 140% |
| Iehp Mcal | $6 | 140% |
| Molina Exchange-All Other Plans | $6 | 140% |
| Molina Medi-Cal | $6 | 140% |
| Multiplan/Phcs - All Plans | $6 - $323 | 140% |
| Redlands Employee | $6 | 140% |
| Foundation Inland Epo-All Other Plans | $7 - $358 | 163% |
| Networks By Design - All Plans | $7 - $336 | 163% |
| Redlands Hmo-All Other Plans | $7 | 163% |
| Zelis Comm-All Other Plans | $7 - $336 | 163% |
| Foundation Inland Ppo | $8 - $381 | 186% |
| Health Payors - All Plans | $8 - $403 | 186% |
| Interplan - All Plans | $8 - $403 | 186% |
| Prime Health - All Plans | $8 | 186% |
| Alpha Care Mg Mcr Adv | $9 - $448 | 210% |
| Central Hlth Plan Mcr Adv-All Plans | $9 - $448 | 210% |
| Clever Care Mcr Adv - All Plans | $9 - $470 | 210% |
| Epic Health Plan Mcr Adv | $9 - $448 | 210% |
| Heritage Prov Ntwrk/Regal Mcr Adv | $9 - $455 | 210% |
| La Salle Hp Mcr Adv-All Plans | $9 - $470 | 210% |
| Prospect Hp-All Plans | $9 - $448 | 210% |
| Providence Clevercare Mcr Adv | $9 - $448 | 210% |
| Providence Oscar-All Other Plans | $9 - $470 | 210% |
| Wellcare/Easy Choice-All Plans | $9 - $439 | 210% |
| Healthnet - All Other Plans | $10 | 233% |
| Alpha Care Mg-All Other Plans | $11 - $560 | 256% |
| Blue Shield Epn | $11 | 256% |
| Kaiser Comm - All Other Plans | $12 | 280% |
| Cigna | $16 | 373% |
| UnitedHealthcare | $16 - $201 | 373% |
| Heritage Prov Ntwrk/Regal - All Other Plans | $17 - $823 | 396% |