Blood test, clotting time (PT/INR)
Facility: Greater El Monte Community Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $84
- Cash Discount Price: $262
- vs. Medicare Baseline: 19.58x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 1958% of the Medicare baseline (a markup of 1858%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bella Vista Medical Group Ipa | $1 - $266 | 23% |
| Employee Health Systems Medical Group | $1 - $118 | 23% |
| Global Care Medical Group Ipa | $1 - $266 | 23% |
| Ahmc Reciprocity Agreement | $2 - $178 | 47% |
| Ahmc Reciprocity Agreement Senior/Commercial | $2 - $178 | 47% |
| Allied Physicians Medical Group | $2 - $178 | 47% |
| Alta Med Health Services Med Grp | $2 - $148 | 47% |
| Blue Cross Blue Shield | $2 - $296 | 47% |
| Good Samaritan Medical Practice Assoc | $2 - $355 | 47% |
| Lincoln Hospital Medical Center | $2 - $178 | 47% |
| Ahmc Healthcare Inc | $3 | 70% |
| Aids Health Foundation | $3 - $4 | 70% |
| Altamed Health Network | $3 - $4 | 70% |
| Avanti | $3 - $5 | 70% |
| Beverly Hospital | $3 - $5 | 70% |
| Blue Shield Of California | $3 - $296 | 70% |
| Brand New Day | $3 - $5 | 70% |
| California Thoroughbred Horesmans Foundation | $3 - $296 | 70% |
| Clinica Medica Familiar | $3 - $296 | 70% |
| Emanate Health | $3 - $5 | 70% |
| Health Net Foundation | $3 - $385 | 70% |
| Healthy Way La | $3 | 70% |
| La Care Health Plan | $3 - $326 | 70% |
| Molina Healthcare Of California | $3 - $231 | 70% |
| Other Non Contracted Medi-Cal Hmo | $3 | 70% |
| State Of California | $3 | 70% |
| Universal Care | $3 - $414 | 70% |
| Veterans Administration | $3 | 70% |
| Alignment Health Plan | $4 | 93% |
| Allied Physicians | $4 - $6 | 93% |
| Apa/Aco Inc | $4 | 93% |
| Associated Hispanic Physicians | $4 | 93% |
| Care 1St Health Plan | $4 - $355 | 93% |
| Cms | $4 | 93% |
| Cost Containment Strategies | $4 - $385 | 93% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $4 | 93% |
| Easy Choice Health Plan | $4 | 93% |
| Health Net Inc | $4 - $419 | 93% |
| Hollywood Presbyterian Adv Med Mcal | $4 | 93% |
| Hollywood Presbyterian Medpoint Mcal | $4 | 93% |
| In Custody Police Dept | $4 - $385 | 93% |
| Inter Valley Health Plan | $4 | 93% |
| Interplan | $4 - $444 | 93% |
| La Care Covered Direct | $4 | 93% |
| Molina Healthcare | $4 | 93% |
| Other Non Contracted Senior Hmo | $4 | 93% |
| Pacific Alliance Medical Center Reciprocal Contract | $4 | 93% |
| Pacificare Of California | $4 - $513 | 93% |
| Scan Health Plan | $4 | 93% |
| Self-Pay | $4 | 93% |
| UnitedHealthcare | $4 - $508 | 93% |
| Ahmc Health Self-Insurance Epo | $5 | 117% |
| Athens Administrators | $5 | 117% |
| Caloptima | $5 | 117% |
| Central Health Plan | $5 - $414 | 117% |
| Champus Foundation | $5 | 117% |
| Chinatown Service Center Pace | $5 | 117% |
| Cigna | $5 | 117% |
| Community Care Network | $5 - $474 | 117% |
| Intercomp | $5 | 117% |
| Knox-Keene Act | $5 | 117% |
| Multiplan | $5 - $503 | 117% |
| Other Non Contracted Work Comp | $5 | 117% |
| Preferred Health Network | $5 | 117% |
| San Miguel Health Plan | $5 | 117% |
| Health Payors Organization | $6 - $533 | 140% |
| Commercial Non Contract | $7 - $592 | 163% |
| Medi-Cal Sub Acute | $7 - $592 | 163% |
| Nuclear Medicine/Whmc | $7 - $592 | 163% |
| One Legacy | $7 - $592 | 163% |
| Care 1St Medi Cal Hmo Cap Exceptional Care | $20 - $59 | 466% |
| Care First Health Plan | $20 - $59 | 466% |
| In Custody-Ca Highway Patrol | $20 | 466% |