CMS Price Transparency Data
Blood test, clotting time (PT/INR)
Facility: Garfield Medical Center
Billing Code: 85610 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85610
- Insurance Median: $13
- Cash Discount Price: $499
- vs. Medicare Baseline: 3.03x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Garfield Medical Center is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $499. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 3.03x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$499
Average discount available for prompt cash payment at this facility.
Insurance Median
$13
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: $499 (11632%)
Insurance Median: $13 (303%)
Cash: $499 (11632% of Medicare)
Ins. Median: $13 (303% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 303% of the Medicare baseline (a markup of 203%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Access Ipa Ancillary | $1 - $188 | 23% |
| Associated Hispanic Phys Of So Cal | $1 - $126 | 23% |
| Care First Health Plan | $1 - $63 | 23% |
| Employee Health Systems Mg | $1 - $126 | 23% |
| Pacific Independent Physician Association | $1 - $100 | 23% |
| UnitedHealthcare | $1 - $377 | 23% |
| Ahmc Healthcare Inc | $2 - $188 | 47% |
| Allied Physicians Risk Pool | $2 - $220 | 47% |
| Allied Physicians Risk Pool Agreement | $2 - $220 | 47% |
| Family Health Alliance | $2 - $188 | 47% |
| Healthnet Medi Cal Cap | $2 - $220 | 47% |
| Pipa Risk Pool Agreement | $2 - $220 | 47% |
| Allied Physicians | $3 - $6 | 70% |
| Beverly Hospital | $3 - $5 | 70% |
| Blue Cross Blue Shield | $3 - $314 | 70% |
| Brand New Day | $3 - $5 | 70% |
| Care 1St Mcl/Gar Cap Reciprocity | $3 | 70% |
| Central Health Plan | $3 - $251 | 70% |
| Community Health Plan | $3 | 70% |
| Emanate Health | $3 - $5 | 70% |
| Health Net | $3 - $528 | 70% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $3 - $251 | 70% |
| Health Net Foundation M Cal (Family Health Alliance) | $3 - $251 | 70% |
| Healthy Way La | $3 | 70% |
| La Care Health Plan | $3 - $345 | 70% |
| Molina Medical Group | $3 - $245 | 70% |
| Other Non-Contracting Medi-Cal | $3 | 70% |
| Phys Assoc Of San Gab Valley | $3 - $251 | 70% |
| Physicians Healthways Medi-Cal | $3 - $628 | 70% |
| Veterans Administration | $3 | 70% |
| Advantage Care Ipa | $4 - $628 | 93% |
| Aetna | $4 - $457 | 93% |
| Aids Health Foundation | $4 | 93% |
| Alhambra Hospital | $4 - $377 | 93% |
| Alignment Health Plan | $4 | 93% |
| Allied Physicians Med Grp | $4 - $314 | 93% |
| Apa Aco Inc | $4 | 93% |
| Avanti | $4 - $5 | 93% |
| Blue Shield | $4 - $55 | 93% |
| Blue Shield Of California | $4 - $314 | 93% |
| Care 1St Health Plan | $4 - $377 | 93% |
| Cms | $4 | 93% |
| Cv-19 Hrsa Uninsured Testing And Tx | $4 | 93% |
| Easy Choice Health Plan | $4 | 93% |
| First Health Network | $4 - $440 | 93% |
| Health Net Comm/Hmo | $4 - $345 | 93% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $4 | 93% |
| Hollywood Presbyterian Medpoint Mcal | $4 | 93% |
| Humana | $4 | 93% |
| Inter Valley Health Plan | $4 | 93% |
| Interplan | $4 - $471 | 93% |
| La Care Covered Direct | $4 | 93% |
| Molina Healthcare | $4 | 93% |
| Molina Healthcare Of California | $4 - $5 | 93% |
| Non-Contract Medi-Care | $4 | 93% |
| Pacific Alliance Medical Center Comm/Sr | $4 | 93% |
| Physicians Healthways Medical Corporation | $4 - $628 | 93% |
| Scan Health Plan Sr Hmo | $4 | 93% |
| Self-Pay | $4 | 93% |
| State Of California Medi-Cal | $4 | 93% |
| Ucla Impact Dept Of Uncology | $4 | 93% |
| Ahmc Health Epo | $5 | 117% |
| Athens Administrators | $5 | 117% |
| Chinatown Service Center Pace | $5 | 117% |
| Cigna | $5 | 117% |
| Fmc Los Angeles Co Epo | $5 - $471 | 117% |
| Knox-Keene Act | $5 | 117% |
| Multiplan | $5 - $534 | 117% |
| National Disaster Medical System | $5 | 117% |
| One Health Plan | $5 - $440 | 117% |
| Other Non-Contracted Workers Compensation | $5 | 117% |
| Physician Healthways Medical Corporation | $5 | 117% |
| Preferred Health Network | $5 | 117% |
| San Miguel Health Plan | $5 | 117% |
| Americas Health Plan | $6 - $534 | 140% |
| Caloptima Direct | $6 | 140% |
| Corvel Corporation | $6 - $502 | 140% |
| Health Payors Organization | $6 - $565 | 140% |
| East La Reg Ctr | $7 - $628 | 163% |
| Health Net Inc | $7 | 163% |
| Non Contract Commercial | $7 - $628 | 163% |
| One Legacy | $7 - $628 | 163% |
| Private Pay | $7 - $628 | 163% |
| Pacificare Of California Inc | $9 | 210% |
| Pacificare Ppo | $9 | 210% |