CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Good Samaritan Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $6
  • Cash Discount Price: $38
  • vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Good Samaritan Hospital is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.40x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.
Cash / Self-Pay
$38

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

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: $38 (886%)
Insurance Median: $6 (140%)
Cash: $38 (886% of Medicare)
Ins. Median: $6 (140% 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
Health Net $1 - $216 23%
Santa Clara Family Health Plan $1 - $176 23%
United $2 - $237 47%
Aetna $4 - $22 93%
Affinity Medical Group $4 93%
Alignment Health Plan $4 93%
Blue Cross Blue Shield $4 - $23 93%
Blue Shield $4 - $7 93%
Care1St Health Plan $4 93%
Central Health Plan $4 93%
Clever Care Of Golden State $4 93%
Easy Choice Health Plan $4 93%
Humana $4 - $650 93%
Managed Health Network $4 93%
Multiplan $4 - $743 93%
Nx Health Network $4 - $557 93%
On Lok Senior Health $4 93%
Palo Alto Medical $4 - $6 93%
Scan Health Plan $4 93%
Sutter Select $4 - $557 93%
Triwest Healthcare Alliance $4 93%
University Healthcare $4 93%
Vitality Health Plan $4 93%
Cigna $5 - $743 117%
Corvel Corporation $5 117%
First Health $5 - $929 117%
Healthsmart $5 - $743 117%
Intercontinental Corporation $5 - $743 117%
Pha Pacific Health Alliance $5 - $743 117%
Physicians Medical Group $5 117%
Ppo Next $5 - $743 117%
Affinity Medical Group Comm $6 140%
Medcare Partners $6 - $139 140%
Canopy $8 186%
Bright Health $9 210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2425 Samaritan Drive, San Jose, CA 95124
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals