CMS Price Transparency Data
Blood test, clotting time (PT/INR)
Facility: AHMC Anaheim Regional Medical Center
Billing Code: 85610 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85610
- Insurance Median: $5
- Cash Discount Price: $193
- vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at AHMC Anaheim Regional Medical Center is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 1111 W La Palma Avenue, Anaheim, CA.
Cash / Self-Pay
$193
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: $193 (4499%)
Insurance Median: $5 (117%)
Cash: $193 (4499% 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
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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 |
|---|---|---|
| Advance Clinical Research Institute | $2 - $60 | 47% |
| Ahmc Reciprocity Agreement | $2 - $60 | 47% |
| Memorial Healthcare Ipa | $2 - $60 | 47% |
| Netcare Life And Health Insurance | $2 - $50 | 47% |
| Affiliated Doctors Of Orange County | $3 | 70% |
| Allied Physicians | $3 - $6 | 70% |
| Altamed Health Network | $3 - $4 | 70% |
| Applecare Medical Group | $3 | 70% |
| Beverly Hospital | $3 - $5 | 70% |
| Brand New Day | $3 - $5 | 70% |
| Health Net | $3 | 70% |
| Healthcare Partners | $3 - $4 | 70% |
| Healthy Way La | $3 | 70% |
| Heritage Provider Network | $3 - $6 | 70% |
| Kaiser Foundation Hospitals | $3 - $4 | 70% |
| Medical Acquisition Company | $3 - $80 | 70% |
| Medical Safety Net Program | $3 | 70% |
| Non Contracted Medi-Cal | $3 | 70% |
| Talbert Medical Group | $3 - $4 | 70% |
| Veterans Administration | $3 | 70% |
| Aetna | $4 - $21 | 93% |
| Aids Health Foundation | $4 | 93% |
| Align Senior Care | $4 | 93% |
| Alignment Health Plan | $4 | 93% |
| Alta Los Angeles Hospital | $4 | 93% |
| Angels Baseball Workers Comp | $4 | 93% |
| Apa Aco Inc | $4 | 93% |
| Avanti | $4 - $5 | 93% |
| Blue Cross Blue Shield | $4 - $15 | 93% |
| Blue Shield Of California | $4 - $53 | 93% |
| Caloptima | $4 - $5 | 93% |
| Central Health Of California | $4 | 93% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $4 | 93% |
| Davita Heatlhcare Partners Plan Inc | $4 - $109 | 93% |
| Emanate Health | $4 - $5 | 93% |
| Genesis Healthcare Ipa Ancillary | $4 - $121 | 93% |
| Health Net Inc | $4 - $154 | 93% |
| Healthcare Partners Commercial | $4 - $109 | 93% |
| Healthnet | $4 | 93% |
| Healthnet Cal Optima Medi-Cal/Healthy Families | $4 | 93% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $4 | 93% |
| Hollywood Presbyterian Medpoint Mcal | $4 | 93% |
| Humana | $4 | 93% |
| Huntington Memorial Hospital | $4 - $109 | 93% |
| Innovative Integrated Health (Iih)/Orange County Pace | $4 | 93% |
| Medi-Cal | $4 | 93% |
| Medicare (plans) | $4 - $100 | 93% |
| Memorial Healthcare Ipa/Cap/Valuation Rates | $4 | 93% |
| Monarch Health Plan | $4 - $136 | 93% |
| Nchp | $4 | 93% |
| Pacificare | $4 | 93% |
| Private Pay Flat Rate | $4 | 93% |
| Prospect Health Plan | $4 - $6 | 93% |
| Prospect Medical Group | $4 | 93% |
| Scan Health Plan | $4 | 93% |
| Self-Pay | $4 | 93% |
| Seoul Medical Group | $4 | 93% |
| Wellcare | $4 | 93% |
| Affiliated Health Fund | $5 - $141 | 117% |
| Ahmc Health Self-Insurance Epo | $5 | 117% |
| Allnet Preferred Provider | $5 - $141 | 117% |
| Athens Administrators | $5 | 117% |
| Capp Care | $5 - $151 | 117% |
| Care First | $5 - $141 | 117% |
| Choicecare | $5 - $151 | 117% |
| Cigna | $5 | 117% |
| Corvel | $5 - $151 | 117% |
| First Health | $5 - $171 | 117% |
| Interplan | $5 - $141 | 117% |
| Knox-Keene Act | $5 | 117% |
| Marriot Intl | $5 | 117% |
| Multiplan Inc | $5 - $151 | 117% |
| Non Contracted Workers Comp | $5 | 117% |
| Orange County Preferred Provider Organization | $5 - $151 | 117% |
| Private Healthcare Systems | $5 - $141 | 117% |
| Tricare | $5 | 117% |
| Health Payors Organization | $6 - $181 | 140% |
| National Provider Network | $6 - $161 | 140% |
| Three Rivers Providers Network | $6 - $161 | 140% |
| Non Contracted Commercial | $7 - $201 | 163% |
| UnitedHealthcare | $9 - $17 | 210% |
| Monarch Healthcare Medical Group | $11 | 256% |
| Msi/Medical Services For Indigents | $52 | 1212% |