Blood test, clotting time (PT/INR)
Facility: Alhambra Hospital Medical Center
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $9
- Cash Discount Price: $206
- vs. Medicare Baseline: 2.10x 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 210% of the Medicare baseline (a markup of 110%). 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-Reciprocity-Medi-Cal/Healthy Families | $3 | 70% |
| Citrus Valley Health Partners | $3 | 70% |
| Kaiser Medi-Cal | $3 | 70% |
| La Care Pasc Seiu Misc | $3 | 70% |
| Miscellaneous Medi-Cal Hmo | $3 | 70% |
| Stewart Mg Senior Hmo | $3 | 70% |
| Aetna | $4 - $7 | 93% |
| Alignment Senior Hmo | $4 | 93% |
| Allied Physicians Of Ca Medi-Cal | $4 | 93% |
| Altamed Senior Services | $4 | 93% |
| Apa Aco | $4 | 93% |
| Blue Cross Blue Shield | $4 - $8 | 93% |
| Blue Shield 65 Plus | $4 | 93% |
| Brand New Day Sr | $4 | 93% |
| Central Health Plan Of Ca Senior Hmo | $4 | 93% |
| Health Net Medi-Cal | $4 | 93% |
| Health Net Senior Hmo | $4 | 93% |
| Humana | $4 | 93% |
| La Care Exchange | $4 | 93% |
| La Care Medi-Cal Hmo | $4 | 93% |
| Medi-Cal | $4 | 93% |
| Medicare (plans) | $4 - $149 | 93% |
| Miscellaneous Senior Hmo | $4 | 93% |
| UnitedHealthcare | $4 - $9 | 93% |
| Wellcare Senior Hmo | $4 | 93% |
| Cigna | $5 - $112 | 117% |
| Health Net Exchange | $5 | 117% |
| Health Net Salud Con Hmo | $5 | 117% |
| Miscellaneous Work Comp Hmo | $5 | 117% |
| Molina Exchange | $5 | 117% |
| Tricare | $5 | 117% |
| Ahmc Health | $6 | 140% |
| Allied Physicians Of Ca Commercial | $6 | 140% |
| Health Net Ppo/Epo/Pos | $9 | 210% |
| Ahmc-Reciprocity-Comm/Senior | $49 - $74 | 1142% |
| Blue Shield Value Network Exchange | $49 | 1142% |
| Blue Shield Hmo/Ppo | $55 | 1282% |
| Allied Physicians Comm/Sr | $58 - $87 | 1352% |
| Allied Physicians Medi-Cal | $58 - $87 | 1352% |
| Wellcare Allied Senior Hmo | $58 - $87 | 1352% |
| Molina Health Plan | $64 - $97 | 1492% |
| Self Pay | $66 - $99 | 1538% |
| Health Net Exchange Enhanced Ppo | $70 - $105 | 1632% |
| Kaiser Commercial | $102 - $154 | 2378% |
| Scan Senior Plan | $107 - $161 | 2494% |
| Multiplan | $132 - $198 | 3077% |
| Miscellaneous Commercial Ppo/Hmo | $165 - $248 | 3846% |