Blood test, clotting time (PT/INR)
Facility: San Gabriel Valley Medical Center
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $15
- Cash Discount Price: $109
- vs. Medicare Baseline: 3.50x 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 350% of the Medicare baseline (a markup of 250%). 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 |
|---|---|---|
| Ahmc Medi-Cal Reciprocity | $3 | 70% |
| Allied Physicians | $3 - $6 | 70% |
| Altamed Health Network | $3 - $4 | 70% |
| Beverly Hospital | $3 - $5 | 70% |
| Brand New Day | $3 - $207 | 70% |
| Emanate Health | $3 - $5 | 70% |
| Healthnet Medi-Cal Non-Contract | $3 | 70% |
| Healthy Way La | $3 | 70% |
| Non Contracting Medi Cal | $3 | 70% |
| Veterans Administration | $3 | 70% |
| Aetna | $4 - $7 | 93% |
| Aids Healthcare Foundation | $4 - $237 | 93% |
| Alignment Health Plan | $4 | 93% |
| Apa/Aco Inc | $4 | 93% |
| Avanti | $4 - $5 | 93% |
| Blue Cross Blue Shield | $4 - $21 | 93% |
| Blue Shield Of California | $4 - $55 | 93% |
| Central Health Plan | $4 - $355 | 93% |
| Cv-19 Hrsa Uninsured Testing And Tx | $4 | 93% |
| Health Net | $4 - $344 | 93% |
| Health Net Inc | $4 - $10 | 93% |
| Hollywood Presbyterian Adv Med Mcal | $4 | 93% |
| Hollywood Presbyterian Medpoint Mcal | $4 | 93% |
| Humana | $4 | 93% |
| Inter Valley Health Plan | $4 | 93% |
| La Care Health Plan | $4 | 93% |
| Medicaid / KanCare | $4 | 93% |
| Medicare (plans) | $4 | 93% |
| Molina Healthcare Of California | $4 - $231 | 93% |
| Pacific Alliance Medical Center | $4 | 93% |
| Pacificare Of California | $4 - $194 | 93% |
| Physicians Healthways | $4 | 93% |
| Providence Health Network | $4 | 93% |
| Self-Pay | $4 | 93% |
| St Vincent Medical Center/Psych | $4 | 93% |
| Tricare | $4 | 93% |
| Wellcare | $4 | 93% |
| Ahmc Health Self-Insurance Epo | $5 | 117% |
| Athens Administrators | $5 | 117% |
| Beech Street | $5 - $474 | 117% |
| Care 1St Health Plan | $5 - $385 | 117% |
| Chinatown Service Center Pace | $5 | 117% |
| Cigna | $5 | 117% |
| Knox-Keene Act | $5 | 117% |
| Other Non Contracting Workers Comp | $5 | 117% |
| UnitedHealthcare | $9 - $17 | 210% |
| Private Pay | $12 | 280% |
| Ahmc Reciprocity | $40 - $178 | 932% |
| Alignment Healthplan | $46 - $207 | 1072% |
| Clever Care | $46 - $207 | 1072% |
| Pacific Independent Physician Associates | $53 - $237 | 1235% |
| Facey Medical | $66 - $296 | 1538% |
| Community Care Network | $86 - $385 | 2005% |
| Choicecare Network | $92 - $414 | 2145% |
| Private Healthcare Systems (Phcs) | $92 - $414 | 2145% |
| Affiliated Health Fund | $99 - $444 | 2308% |
| Multiplan | $119 - $533 | 2774% |
| Ppo Next | $119 - $533 | 2774% |
| Managed Health Network | $132 - $592 | 3077% |
| Medi-Cal Sub Acute | $132 - $592 | 3077% |
| One Legacy | $132 - $592 | 3077% |
| Other Non Contracted Commercial | $132 - $592 | 3077% |
| Us Behavioral Health Plan | $132 - $592 | 3077% |