CMS Price Transparency Data
Blood test, clotting time (PT/INR)
Facility: Menifee Global Medical Center
Billing Code: 85610 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85610
- Insurance Median: $5
- Cash Discount Price: $161
- vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Menifee Global Medical Center is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $161. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 28400 McCall Boulevard, Sun City, CA.
Cash / Self-Pay
$161
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%)
Cash / Self-Pay: $161 (3753%)
Insurance Median: $5 (117%)
Cash: $161 (3753% of Medicare)
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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Ic | $3 - $161 | 70% |
| Kaiser Medi-Cal | $3 | 70% |
| Aetna | $4 - $102 | 93% |
| Altamed Comm Hmo (Ancillary) | $4 - $161 | 93% |
| Altamed Health Services Senior | $4 | 93% |
| Altamed Sr/Pace | $4 | 93% |
| Blue Cross Blue Shield | $4 | 93% |
| Blue Shield Senior | $4 | 93% |
| Central Health Plan Senior | $4 | 93% |
| Clever Care Health Plan Sr | $4 | 93% |
| For Your Benefit Senior | $4 | 93% |
| Guidant Health Plan Senior | $4 | 93% |
| Health Net Medi-Cal | $4 | 93% |
| Health Net Senior | $4 | 93% |
| Hpn Mcal | $4 | 93% |
| Hpn Senior | $4 | 93% |
| Humana | $4 | 93% |
| Imperial Health Plan Of Ca | $4 | 93% |
| Kaiser Senior | $4 | 93% |
| Lasalle Medical Assoc (Ancillary) Commercial | $4 | 93% |
| Lasalle Medical Assoc (Ancillary) Mcal Hmo | $4 | 93% |
| Lasalle Medical Assoc (Ancillary) Senior | $4 | 93% |
| Managed Health Network Sr | $4 | 93% |
| Medicare (plans) | $4 | 93% |
| Molina Medi-Cal | $4 | 93% |
| Neighborhood Healthcare Pace | $4 | 93% |
| Point Comfort Underwriters | $4 | 93% |
| Primecare Senior | $4 | 93% |
| Prospect Health Plan Mcal Hmo | $4 | 93% |
| Prospect Health Plan Sr Hmo | $4 | 93% |
| Scan Senior | $4 | 93% |
| Self Pay/Ab774/Charity Discount | $4 | 93% |
| Sr Capitation | $4 | 93% |
| Tricare | $4 | 93% |
| UnitedHealthcare | $4 - $5 | 93% |
| Veterans Administration | $4 | 93% |
| Align Senior Care | $5 | 117% |
| Coventry | $5 | 117% |
| Iehp Covered Ca | $5 | 117% |
| Iehp Medi-Cal | $5 | 117% |
| Molina Covered Ca | $5 | 117% |
| Prime Health Services Senior | $5 | 117% |
| Prime Health Services Wcomp | $5 | 117% |
| Three Rivers Wcomp | $5 | 117% |
| Welbehealth Sr/Pace | $5 | 117% |
| Workers Comp Non-Contracted | $5 | 117% |
| Altamed Mcal Hmo | $6 | 140% |
| Altamed Mcal/Pace | $6 | 140% |
| Choice Physicians Network | $6 | 140% |
| Health Net Comm | $6 | 140% |
| Health Net Enhanced Ppo | $6 | 140% |
| Hpn Commercial/Covered Ca | $6 | 140% |
| Prospect Health Plan Comm Hmo | $6 | 140% |
| Cigna | $8 - $129 | 186% |
| Three Rivers Network | $8 | 186% |
| Velocity | $8 - $72 | 186% |
| Blue Shield Epn | $12 | 280% |
| Blue Shield Commercial | $14 | 326% |
| First Health Commercial | $85 | 1981% |
| Primecare Commercial | $105 | 2448% |
| Multiplan Ppo | $113 | 2634% |
| Multiplan Wcomp | $113 | 2634% |
| Pnoa-Provider Network Of America | $129 | 3007% |
| Prime Health Services Commercial | $129 | 3007% |
| Ava Hospice | $161 | 3753% |
| Kaiser Commercial | $161 | 3753% |
| Living Waters Hospice | $161 | 3753% |
| Managed Health Network | $161 | 3753% |
| Other Insurance Loa | $161 | 3753% |
| Pacific Valley Hospice | $161 | 3753% |
| Private Pay | $161 | 3753% |
| Silverado Hospice | $161 | 3753% |
| Vna Hospice | $161 | 3753% |