CMS Price Transparency Data
Blood test, clotting time (PT/INR)
Facility: Monterey Park Hospital
Billing Code: 85610 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85610
- Insurance Median: $5
- Cash Discount Price: $9
- vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Monterey Park Hospital is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 900 S Atlantic Blvd, Monterey Park, CA.
Cash / Self-Pay
$9
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: $9 (210%)
Insurance Median: $5 (117%)
Cash: $9 (210% 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
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 |
|---|---|---|
| Ahmc Healthcare Inc | $1 - $103 | 23% |
| Ahmc Reciprocity Agreement Senior/Commercial | $1 - $103 | 23% |
| Allied Physicians Ipa | $1 - $103 | 23% |
| Alta Med Health Services Corp | $1 - $86 | 23% |
| Altamed Health Services Corporation | $1 - $34 | 23% |
| Bella Vista Medical Group | $1 - $103 | 23% |
| Care 1St M Cal | $1 - $34 | 23% |
| Community Health Plan M Cal Joy Ipa | $1 - $103 | 23% |
| Crown City Medical Group Inc | $1 - $34 | 23% |
| Employee Health Systems Medical Group | $1 - $68 | 23% |
| Esperanza Medical Group Ipa | $1 - $103 | 23% |
| Family Health Alliance Medical Group | $1 - $103 | 23% |
| Garfield Medical Center | $1 - $34 | 23% |
| Global Care Medical Group Ipa | $1 - $154 | 23% |
| Healthnet/Ehs Capitation | $1 - $68 | 23% |
| Hispanic Physicians Ipa Medical Corporation | $1 - $86 | 23% |
| Pacific Independent Physician Association | $1 - $103 | 23% |
| Physician Healthways | $1 - $86 | 23% |
| Tenet Reciprocity | $1 - $103 | 23% |
| Universal Care M Cal/Advantage Health Network | $1 - $34 | 23% |
| Blue Cross Blue Shield | $2 - $171 | 47% |
| Blue Shield Of California | $2 - $171 | 47% |
| Central Health Plan Of California | $2 - $137 | 47% |
| Healthcare Partners Affiliates Medical Group | $2 - $122 | 47% |
| Molina Medical Centers | $2 - $133 | 47% |
| Access Ipa Ancillary | $3 - $4 | 70% |
| Accountable Ipa | $3 | 70% |
| Aetna | $3 - $249 | 70% |
| Alhambra Community Dialysis Unit Inc | $3 - $205 | 70% |
| Allied Physicians | $3 - $6 | 70% |
| Altamed Health Network | $3 - $4 | 70% |
| Altamed Health Services | $3 | 70% |
| Applecare Medical Group | $3 | 70% |
| Assess Ipa | $3 | 70% |
| Associated Hispanic Physicians Ancillary | $3 - $4 | 70% |
| Bella Vista Medical Group Ancillary | $3 | 70% |
| Beverly Hospital | $3 - $5 | 70% |
| Brand New Day | $3 - $5 | 70% |
| Care 1St Health Plan | $3 - $205 | 70% |
| Care 1St Mcl/Gar Cap | $3 | 70% |
| Central Health Plan | $3 | 70% |
| Choice Care Network | $3 - $222 | 70% |
| Community Health Plan | $3 | 70% |
| Greater Los Angeles Dialysis Inc | $3 - $205 | 70% |
| Health Net | $3 - $222 | 70% |
| Health Net Inc | $3 - $242 | 70% |
| Health Net Medi Cal | $3 | 70% |
| Health Net Of California | $3 - $205 | 70% |
| Healthnet | $3 - $222 | 70% |
| Healthnet Inc | $3 | 70% |
| Healthy Way La | $3 | 70% |
| Interplan | $3 - $256 | 70% |
| La Care | $3 - $4 | 70% |
| La Care Health Plan | $3 - $188 | 70% |
| Medical Managed Care Program | $3 | 70% |
| Molina Healthcare | $3 | 70% |
| One Health Plan | $3 - $775 | 70% |
| Other Non-Contracted Medi-Cal | $3 | 70% |
| Preferred Ipa | $3 - $5 | 70% |
| Preferred Ipa Of California | $3 | 70% |
| UnitedHealthcare | $3 - $239 | 70% |
| Universal Care | $3 - $239 | 70% |
| Veterans Administration | $3 | 70% |
| Aids Health Foundation | $4 - $5 | 93% |
| Alignment Health Plan | $4 | 93% |
| Apa/Aco Inc | $4 | 93% |
| Avanti | $4 - $5 | 93% |
| Bce Emergis Corp | $4 - $291 | 93% |
| Cms | $4 | 93% |
| Corvel Corporation | $4 - $925 | 93% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $4 | 93% |
| Easy Choice Health Plan | $4 | 93% |
| Emanate Health | $4 - $5 | 93% |
| First Health Senior | $4 | 93% |
| Foundation Health Plan | $4 | 93% |
| Hollywood Presbyterian Adv Med Mcal | $4 - $5 | 93% |
| Hollywood Presbyterian Medpoint Mcal | $4 - $5 | 93% |
| Humana | $4 | 93% |
| La Care Covered Direct | $4 | 93% |
| Maxi Med Inc/Ipa | $4 - $5 | 93% |
| Medi Cal | $4 - $5 | 93% |
| Medicare (plans) | $4 | 93% |
| Molina Healthcare Medi-Connect | $4 | 93% |
| Multiplan | $4 - $291 | 93% |
| Preferred Health Network | $4 - $274 | 93% |
| Scan Health Plan | $4 | 93% |
| Secure Horizons | $4 | 93% |
| Self-Pay | $4 | 93% |
| Senior Citizens Choice | $4 | 93% |
| Ucla/Impact Cancer | $4 | 93% |
| Ahmc Health Epo | $5 | 117% |
| Asi Flex Ppo W/C | $5 | 117% |
| Athens Administrators | $5 | 117% |
| Caloptima Direct | $5 - $6 | 117% |
| Cigna | $5 | 117% |
| Commercial Non Contract | $5 - $342 | 117% |
| Indemnity W Comp Fee Schedule | $5 | 117% |
| Knox-Keene Act | $5 | 117% |
| Molina Healthcare Of California | $5 | 117% |
| Mri/Ct Greater El Monte Hospital | $5 - $342 | 117% |
| Mri/Mra/Alhambra Hospital | $5 - $342 | 117% |
| Mri/Mra/Eladh | $5 - $342 | 117% |
| One Legacy | $5 - $342 | 117% |
| San Miguel Health Plan | $5 | 117% |
| Pacificare | $9 - $17 | 210% |