CMS Price Transparency Data
Blood test, clotting time (PT/INR)
Facility: Watsonville Community Hospital
Billing Code: 85610 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85610
- Insurance Median: $86
- Cash Discount Price: $93
- vs. Medicare Baseline: 20.05x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Watsonville Community Hospital is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $93. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 20.05x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$93
Average discount available for prompt cash payment at this facility.
Insurance Median
$86
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: $93 (2168%)
Insurance Median: $86 (2005%)
Cash: $93 (2168% of Medicare)
Ins. Median: $86 (2005% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 2005% of the Medicare baseline (a markup of 1905%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Ace-Usa | $4 | 93% |
| Alignment Health Plan | $4 | 93% |
| Beta Healthcare Group | $4 | 93% |
| Blue Shield Ppo | $4 - $14 | 93% |
| Crawford & Co | $4 | 93% |
| Fireman'S Fund Work Comp | $4 | 93% |
| Fleming & Associates | $4 | 93% |
| Gallagher Bassett Svcs | $4 | 93% |
| Hartford Workers' Comp | $4 | 93% |
| Health Net Of California | $4 - $97 | 93% |
| Keenan & Assoc Work Comp | $4 | 93% |
| Kemper Group Workers Comp | $4 | 93% |
| Liberty Mutual Work Comp | $4 | 93% |
| Medicare (plans) | $4 | 93% |
| Miscellaneous Work Comp | $4 | 93% |
| Nx Health Network | $4 | 93% |
| Pinnacle Healthcare Uc | $4 | 93% |
| Republic Idemnity W/Comp | $4 | 93% |
| Secure Horizons | $4 | 93% |
| Secure Horizons Dign Hmo | $4 - $31 | 93% |
| Travelers Insurance | $4 - $155 | 93% |
| Tricare | $4 | 93% |
| U.S. Dept. Of Labor | $4 | 93% |
| UnitedHealthcare | $4 - $93 | 93% |
| Veterans Administration | $4 | 93% |
| Western Growers Work Comp | $4 | 93% |
| Workers Comp | $4 | 93% |
| Alliance/Sccho | $5 | 117% |
| California Childrens Srvs | $5 | 117% |
| Ccs/Monterey County | $5 | 117% |
| Healthy Families | $5 - $14 | 117% |
| Medi-Cal E.R. | $5 | 117% |
| Medi-Cal/Eds | $5 | 117% |
| Medicaid / KanCare | $5 | 117% |
| Well Path | $5 - $155 | 117% |
| Aetna | $13 - $127 | 303% |
| Blue Cross Blue Shield | $13 - $138 | 303% |
| Blue Shield Hmo | $13 - $31 | 303% |
| Cigna | $13 - $109 | 303% |
| Great-West/Phcs | $13 - $109 | 303% |
| Health Net Pmg Hmo | $13 - $97 | 303% |
| Pacificare Hmo | $13 - $93 | 303% |
| Bs Employee | $14 | 326% |
| Ufcw/Valley Clerks | $14 | 326% |
| United Agriculture | $14 | 326% |
| Calif Ironworkers Field | $26 - $138 | 606% |
| Carpenters H&W Trust | $26 - $138 | 606% |
| City Of Wats/Pinnacle Clm | $26 - $138 | 606% |
| Claims Management Wc | $26 - $138 | 606% |
| Delta Health Systems | $26 - $138 | 606% |
| Laborers Health & Welfare | $26 - $138 | 606% |
| Monterey Bay Pub Emp Trst | $26 - $138 | 606% |
| Operating Engineers | $26 - $138 | 606% |
| Pinnacle Claims Tpa/Bc | $26 - $138 | 606% |
| Robert Kennedy/Ccn | $26 - $138 | 606% |
| Sheet Metal Workers | $26 - $138 | 606% |
| State Compensation Fund | $26 - $138 | 606% |
| Teamsters Benefit Trust | $26 - $138 | 606% |
| Western Growers Trust/Bc | $26 - $138 | 606% |
| Medicruz | $28 | 653% |
| Victim Compensation Plan | $28 - $155 | 653% |
| Western Health Advantage | $78 | 1818% |
| Health Net Smartcare Netw | $93 | 2168% |
| Pacificare Ppo | $93 | 2168% |
| Self Pay | $93 | 2168% |
| Health Net Blue And Gold | $97 | 2261% |
| Health Net Canopycare Hmo | $97 | 2261% |
| Adventist Risk Management | $109 - $124 | 2541% |
| First Health | $109 - $124 | 2541% |
| Geha (Ccn) | $109 - $124 | 2541% |
| Transwestern | $109 - $124 | 2541% |
| Multiplan Inc Ppo | $121 | 2821% |
| Private Healthcare System | $121 | 2821% |
| Coastal Healthcare Admin | $132 - $140 | 3077% |
| Salinas Valley Mem Hops | $132 | 3077% |
| Aaa | $155 | 3613% |
| Aarp | $155 | 3613% |
| Allstate | $155 | 3613% |
| Apwu Health Plan | $155 | 3613% |
| Bankers Life & Casualty | $155 | 3613% |
| Farmers Insurance | $155 | 3613% |
| Humana | $155 | 3613% |
| Miscellaneous Auto | $155 | 3613% |
| Miscellaneous Insurance | $155 | 3613% |
| North Calif Bakery Driver | $155 | 3613% |
| Physicians Mutual | $155 | 3613% |
| Prucare Pmg Hmo | $155 | 3613% |
| Prucare Pmg Pos | $155 | 3613% |
| State Farm Ins | $155 | 3613% |
| Sutter Health Plus | $155 | 3613% |
| United Administrative | $155 | 3613% |
| Wholesale Beer Distributo | $155 | 3613% |
| Zenith National Ins | $155 | 3613% |