CMS Price Transparency Data
Blood test, clotting time (PT/INR)
Facility: Whittier Hospital Medical Center
Billing Code: 85610 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85610
- Insurance Median: $5
- Cash Discount Price: $2
- vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Whittier Hospital Medical Center is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 9080 Colima Rd, Whittier, CA.
Cash / Self-Pay
$2
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: $2 (47%)
Insurance Median: $5 (117%)
Cash: $2 (47% 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 |
|---|---|---|
| Physician Healthways | $1 - $27 | 23% |
| Ahmc Reciprocity | $2 - $80 | 47% |
| Ahmc Reciprocity Agreement Senior/Commercial | $2 - $80 | 47% |
| Pacific Independent Physician Association | $2 - $80 | 47% |
| Physicians Healthways Medical Corporation | $2 - $66 | 47% |
| Wear And Wood | $2 - $106 | 47% |
| Ahmc Medi-Cal Reciprocity Agreement | $3 | 70% |
| Aids Healthcare Foundation | $3 - $4 | 70% |
| Allied Physicians | $3 - $6 | 70% |
| Allied Physicians Ipa | $3 - $120 | 70% |
| Alta Med Health Network | $3 - $4 | 70% |
| Altamed Health Services Corporation | $3 | 70% |
| Beverly Hospital | $3 - $5 | 70% |
| Blue Cross Blue Shield | $3 - $133 | 70% |
| Brand New Day | $3 - $5 | 70% |
| Central Health Plan Of California | $3 - $106 | 70% |
| Edward Medical Group | $3 - $93 | 70% |
| Emanate Health | $3 - $5 | 70% |
| Health Net | $3 - $159 | 70% |
| Healthy Way La | $3 | 70% |
| Heritage Provider Network | $3 - $6 | 70% |
| Kaiser Foundation | $3 - $186 | 70% |
| La Care Healthy Families/Healthy Kids | $3 | 70% |
| Molina Medical Center | $3 - $104 | 70% |
| Non Contracted Medi-Cal | $3 | 70% |
| Prospect Health Plan | $3 - $7 | 70% |
| Synermed | $3 - $4 | 70% |
| UnitedHealthcare | $3 - $231 | 70% |
| Veterans Administration | $3 | 70% |
| Aetna | $4 - $194 | 93% |
| Alignment Health Plan | $4 | 93% |
| Alta Los Angeles Hospitals Inc | $4 | 93% |
| Apa/Aco Inc | $4 | 93% |
| Avanti | $4 - $5 | 93% |
| Blue Shield Of California | $4 - $133 | 93% |
| Caloptima | $4 - $5 | 93% |
| Care 1St Health Plan | $4 - $160 | 93% |
| Care First Health Plan | $4 | 93% |
| Caremore | $4 | 93% |
| Central Health Plan | $4 | 93% |
| County Of Los Angeles Dept Of Health Services | $4 | 93% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $4 | 93% |
| Easy Choice Health Plan | $4 | 93% |
| Hollywood Presbyterian Adv Med Mcal | $4 | 93% |
| Hollywood Presbyterian Medpoint Mcal | $4 | 93% |
| Humana | $4 | 93% |
| La Care Covered Direct | $4 | 93% |
| La Care Health Plan | $4 - $146 | 93% |
| Medi Caid/ Medi Cal | $4 | 93% |
| Medicare (plans) | $4 | 93% |
| Molina Healthcare Of California | $4 | 93% |
| New Horizon Medical Group Inc | $4 - $160 | 93% |
| Pacific Alliance Medical Center | $4 | 93% |
| Pacificare Of California | $4 | 93% |
| Private Pay | $4 | 93% |
| Prospect Medical | $4 - $146 | 93% |
| Scan Health Plan | $4 | 93% |
| Self-Pay | $4 | 93% |
| Ahmc Health | $5 | 117% |
| Applecare Medical Group | $5 | 117% |
| Asi/Flex | $5 - $186 | 117% |
| Athens Administrators Ahmc Work Comp | $5 | 117% |
| Chinatown Service Center Pace | $5 | 117% |
| Cigna | $5 | 117% |
| Community Care Network | $5 - $200 | 117% |
| Cost Containment | $5 - $173 | 117% |
| Coventry Health Care | $5 - $200 | 117% |
| Coventry Health Care National Network | $5 - $200 | 117% |
| Davita Healthcare Partners | $5 - $173 | 117% |
| Fmc Los Angeles County | $5 - $200 | 117% |
| Health Net Inc | $5 - $173 | 117% |
| Healthnet | $5 - $185 | 117% |
| Interplan Corporation | $5 - $200 | 117% |
| Interplan Health Group | $5 | 117% |
| Knox-Keene Act | $5 | 117% |
| Managed Care Administrators | $5 - $200 | 117% |
| Misc 1 | $5 | 117% |
| Monarch Healthplan | $5 | 117% |
| Multiplan Wc | $5 | 117% |
| Prohealth | $5 - $200 | 117% |
| San Miguel Health Plan | $5 | 117% |
| Tricare | $5 | 117% |
| Universal Care | $5 - $186 | 117% |
| Us Comp Care | $5 - $186 | 117% |
| Value Healthplan Of California | $5 - $186 | 117% |
| Multiplan | $6 - $226 | 140% |
| Commercial Non Contract | $7 - $266 | 163% |
| Medi-Cal Sub Acute | $7 - $266 | 163% |
| One Legacy | $7 - $266 | 163% |
| Capnet | $11 | 256% |
| Great-West Healthcare Of California | $2,500 | 58275% |