Blood test, clotting time (PT/INR)
Facility: Loma Linda University Medical Center
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $29
- Cash Discount Price: $44
- vs. Medicare Baseline: 6.76x 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 676% of the Medicare baseline (a markup of 576%). 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 |
|---|---|---|
| UnitedHealthcare | $3 - $4 | 70% |
| Adventist Health | $4 - $24 | 93% |
| Alpha Care Medical Group | $4 - $6 | 93% |
| Dignity Health | $4 - $6 | 93% |
| Epic Health Plan | $4 - $49 | 93% |
| Inland Empire Health Plan (Iehp) | $4 - $6 | 93% |
| Kaiser Foundation Hospitals | $4 - $81 | 93% |
| Upland Medical Group | $4 | 93% |
| Vantage Medical Group | $4 - $6 | 93% |
| Prime Health Services | $5 - $104 | 117% |
| Riverside University Health System | $5 | 117% |
| Blue Cross Blue Shield | $6 - $29 | 140% |
| Molina Healthcare Of Ca | $6 | 140% |
| Heritage Provider Network | $7 | 163% |
| Lluh Dept Of Risk Management | $8 - $24 | 186% |
| Blue Shield Of California | $17 - $59 | 396% |
| Global Benefits Group | $25 - $73 | 583% |
| Temecula Valley Physicians Medical Group | $25 - $59 | 583% |
| Trivalley Medical Group | $25 - $59 | 583% |
| Aetna | $26 - $59 | 606% |
| Cigna | $27 - $72 | 629% |
| Networks By Design | $27 - $79 | 629% |
| Multiplan | $32 - $92 | 746% |
| Central Health Plan | $34 - $98 | 793% |
| Galaxy Health | $36 - $104 | 839% |
| Health Management Network | $38 - $110 | 886% |