CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Sharp Chula Vista Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $61
Cash Discount Price: $52
vs. Medicare Baseline: 14.22x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Sharp Chula Vista Medical Center is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 14.22x the Medicare baseline. Located in 751 Medical Center Court, Chula Vista, CA.

Cash / Self-Pay

$52

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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: $52 (1212%)

Insurance Median: $61 (1422%)

Cash: $52 (1212% of Medicare)

Ins. Median: $61 (1422% 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 1422% of the Medicare baseline (a markup of 1322%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$1 - $95	23%
Blue Shield	$1 - $124	23%
Health Net	$1 - $114	23%
Managed Health Network	$1 - $9	23%
Molina	$1 - $86	23%
Cigna	$4 - $89	93%
UnitedHealthcare	$4 - $72	93%
Kaiser	$5 - $104	117%
County Medical Services	$6 - $86	140%
Epic Americas	$6 - $88	140%
Indian Health Council	$7 - $104	163%
Medicare (plans)	$7 - $70	163%
Multiplan	$7 - $36	163%
San Diego Pace	$7 - $83	163%
Allianz Global Assistance	$8 - $71	186%
Blue Cross Blue Shield	$8 - $124	186%
California Health And Wellness	$8 - $80	186%
Community Health Group	$8 - $95	186%
Medi-Cal	$9 - $102	210%
Humana	$85 - $89	1981%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $52.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sharp Chula Vista Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85610.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.