Blood test, clotting time (PT/INR)
Facility: Scripps Memorial Hospital - Encinitas
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $15
- Cash Discount Price: $26
- vs. Medicare Baseline: 3.50x 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 350% of the Medicare baseline (a markup of 250%). 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 |
|---|---|---|
| Aetna | $4 - $52 | 93% |
| Alignment Health Plan [443] | $4 | 93% |
| Astiva Mcr Adv [464] | $4 | 93% |
| Bc Mcr Adv [830] | $4 | 93% |
| Blue Cross Blue Shield | $4 - $27 | 93% |
| Bs Mcr Adv [829] | $4 | 93% |
| Central Health Mcr Adv [441] | $4 | 93% |
| Cigna | $4 - $36 | 93% |
| Clever Care Mcr Adv [465] | $4 | 93% |
| D-Snp Mcr Adv [889] | $4 | 93% |
| Dsnp/Csnp - Generic [458] | $4 | 93% |
| Family Health Centers Pace Mcr Adv Hmo [556] | $4 | 93% |
| Family Health Centers Pace Medi-Cal [555] | $4 | 93% |
| Gary And Mary West Pace Medi-Cal Hmo [557] | $4 | 93% |
| Gpmg/Altura - Mcr Adv [888] | $4 | 93% |
| Hn Mcr Adv [832] | $4 | 93% |
| Humana | $4 | 93% |
| Integrated Health Partners - Mcr Adv [895] | $4 | 93% |
| Kaiser Northern Ca Region Mcr Adv [386] | $4 | 93% |
| La Care Mcr Adv Hmo [612] | $4 | 93% |
| Medicare (plans) | $4 | 93% |
| Mpmg Mcr Adv [836] | $4 | 93% |
| Mpmg [800] | $4 | 93% |
| Ocn Mcr Adv [890] | $4 | 93% |
| San Diego Pace Medi-Cal [553] | $4 | 93% |
| Scan Mcr Adv [835] | $4 | 93% |
| Scan [500] | $4 | 93% |
| Scan [818] | $4 | 93% |
| Sharp Comm Med Grp Mcr Adv [840] | $4 | 93% |
| Sharp Health Plan Mcr Adv [531] | $4 | 93% |
| Sharp Health Plan Mcr Adv [897] | $4 | 93% |
| Sharp Rees Stealy Med Grp Mcr Adv [841] | $4 | 93% |
| St Paul'S Pace Medi-Cal [551] | $4 | 93% |
| Ucsd Mcr Adv [873] | $4 | 93% |
| Uh Mcr Adv [831] | $4 | 93% |
| Uh Palomar Health Mcr Adv [885] | $4 | 93% |
| UnitedHealthcare | $4 - $36 | 93% |
| Health Net [340] | $7 - $35 | 163% |
| Prime Healthcare [614] | $7 | 163% |
| Prospect Med Group [893] | $8 | 186% |
| Radys Cpmg [803] | $8 | 186% |
| Mc Alignment [917] | $15 | 350% |
| Mc Blue Shield Promise Health Plan [914] | $15 | 350% |
| Mc Blue Shield [902] | $15 | 350% |
| Mc Health Net [904] | $15 | 350% |
| Mc Scan [905] | $15 | 350% |
| Mc United [906] | $15 | 350% |
| Bc [814] | $23 | 536% |
| Imperial County Phys Med Group [855] | $23 - $35 | 536% |
| Integrated Health Partners [894] | $23 | 536% |
| Perlman Med Group [899] | $23 | 536% |
| Sharp Comm Med Grp [812] | $23 - $47 | 536% |
| Sharp Rees Stealy Med Grp [811] | $23 - $47 | 536% |
| Ucsd [807] | $23 - $47 | 536% |
| Centivo [581] | $24 | 559% |
| Blue Shield [230] | $34 - $37 | 793% |
| Bs [816] | $35 - $37 | 816% |
| Hn [815] | $35 | 816% |
| Uh [819] | $36 | 839% |
| Rady Children'S Hospital [825] | $42 | 979% |
| Palomar Health [892] | $47 | 1096% |
| Veba Med Grp [813] | $47 | 1096% |
| Kaiser Northern Ca Region Hmo/Ppo [384] | $59 | 1375% |
| Kaiser [380] | $59 | 1375% |
| Kaiser [383] | $59 | 1375% |
| Multi Plan Network [470] | $73 | 1702% |
| First Health Network [330] | $77 | 1795% |
| Pnoa [615] | $77 | 1795% |
| Choice Care Network [270] | $82 | 1911% |
| Healthsmart [350] | $82 | 1911% |