CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Adventist Health Sierra Vista

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Adventist Health Sierra Vista is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 1010 Murray St, San Luis Obispo, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$5

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%)
Insurance Median: $5 (117%)
Ins. Median: $5 (117% 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
Hpn-Heritage Prov Ntwrk-All Plans $2 47%
UnitedHealthcare $2 - $4 47%
Aetna $4 93%
Cencal Mcr Adv - All Other Plans $4 93%
Tricare $4 93%
Blue Shield Epo/Ppo-All Other Plans $5 117%
Nbd-Ntwrks By Design Exclus-All Other Plans $5 117%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans $6 140%
Blue Shield Promise Mcal $7 163%
Ah Employee Health Plan - All Plans $8 186%
Coalinga-All Plans $8 186%
Medi-Cal $9 210%
Nbd-Ntwrks By Design Non-Exclus $73 1702%
Blue Shield Epn $465 10839%
Blue Shield Hmo/Pos $578 13473%
Cencal Mcal $1,351 31492%
Ccah-Centrl Ca Allince Mcal-All Plans $1,540 35897%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1010 Murray St, San Luis Obispo, CA 93405
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals