CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Adventist Health Reedley

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $7
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Adventist Health Reedley is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.
Cash / Self-Pay
$7

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: $7 (163%)
Insurance Median: $5 (117%)
Cash: $7 (163% 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
Bc Mcal $1 - $3 23%
Healthnet Medi-Cal $1 - $21 23%
UnitedHealthcare $1 - $59 23%
Blue Shield Epn - All Other Plans $2 - $62 47%
Blue Shield Non Epn $2 - $72 47%
Cigna $2 - $92 47%
Healthnet- All Other Plans $2 - $61 47%
Kaiser - All Other Plans $2 - $70 47%
Western Growers/Pinnacle- All Plans $2 - $65 47%
Cal Viva Hlth Mcal - All Plans $3 - $5 70%
Central Ca Alliance Mcal Profee Only $3 70%
Community Care Ipa Mcal-All Plans $3 - $6 70%
Dignity Mcal Op/Profee Only-All Other Plans $3 - $5 70%
Kern Health Systems Mcal-All Plans $3 - $5 70%
Medi-Cal $3 - $5 70%
Physicians Med Group Op/Profee Only- All Plans $3 - $113 70%
Upn Mcal Profee Only-All Other Plans $3 70%
Blue Shield Mcare $4 93%
Dignity Mcr Adv Op/Profee Only $4 93%
Fhcn Pace Mcr Adv-All Plans $4 93%
Healthnet- Mcr Adv $4 93%
Kaiser Mcr Adv $4 - $6 93%
Lasalle Med Assoc Profee Only - All Plans $4 93%
Phs Prime Health Srvcs $4 93%
Tricare $4 93%
Upn Mcr Adv Profee Only $4 93%
Aetna $5 - $23 117%
Ah Employee Health Plan - All Plans $5 - $8 117%
Central Ca Alliance Ccs Profee Only $5 117%
Central Ca Alliance Comm Profee Only - All Other P $5 117%
Bright Health Mcr Adv - All Plans $7 163%
Central Ca Alliance Chdp Profee Only $7 163%
Blue Cross Blue Shield $9 - $50 210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 372 W Cypress Ave, Reedley, CA 93654
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals