CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: AHMC Seton Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $4
  • Cash Discount Price: $37
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at AHMC Seton Medical Center is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 1900 Sullivan Avenue, Daly City, CA.
Cash / Self-Pay
$37

Average discount available for prompt cash payment at this facility.

Insurance Median
$4

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: $37 (862%)
Insurance Median: $4 (93%)
Cash: $37 (862% of Medicare)
Ins. Median: $4 (93% 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
Self Pay $1 - $76 23%
Blue Cross Blue Shield $2 - $169 47%
Chinese Community Health Plan $2 - $112 47%
Healthcare Foundation Of San Mateo $2 - $167 47%
Interplan Corporation $2 - $134 47%
Jade Health Care Mg $2 - $112 47%
Veterans Administration (Va) $2 - $3 47%
Aetna $3 - $12 70%
Apcmg $3 - $6 70%
Asian American Medical Group $3 - $5 70%
Athens Administrators $3 - $5 70%
Beech Street Corporation $3 - $178 70%
Blue Shield Of California $3 - $50 70%
Brand New Day $3 - $5 70%
Brown And Toland Medical Group $3 - $5 70%
Canopy Health $3 - $8 70%
Care Advantage $3 - $4 70%
Choicecare Network $3 - $190 70%
Cigna $3 - $20 70%
Cmac $3 - $4 70%
Corvel Healthcare $3 - $5 70%
Covid-19 Uninsured Program $3 - $4 70%
Easy Choice Hospital Services $3 - $4 70%
For Your Benefit $3 - $4 70%
Health Net $3 - $171 70%
Health Plan Of San Mateo $3 - $6 70%
Health Plan Of San Mateo Healthworx $3 - $5 70%
Healthnet Seniority $3 - $4 70%
Hill Physicians Medical Group Inc $3 - $5 70%
Humana $3 - $4 70%
Imperial Health Plan $3 - $4 70%
Indemnity $3 - $223 70%
Kaiser $3 - $183 70%
Knox-Keene Act $3 - $5 70%
Medi-Cal $3 70%
Medicare (plans) $3 - $4 70%
Mills Peninsula Health Services $3 - $201 70%
Multiplan $3 - $190 70%
Multiplan/Bce Emergis $3 - $167 70%
North East Medical Services $3 - $5 70%
Pacificare $3 - $4 70%
Private Healthcare Sytems Inc $3 - $167 70%
San Francisco Health Plan $3 - $5 70%
San Mateo County/San Mateo County General Hospital $3 - $4 70%
The First Health Network $3 - $167 70%
Tricare $3 - $5 70%
UnitedHealthcare $3 - $9 70%
Work Comp Other $3 - $5 70%
Workers Compensation Federal $3 - $13 70%
Ahmc Health $4 - $5 93%
Central Health Plan $4 - $5 93%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Sullivan Avenue, Daly City, CA 94015
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals