Blood test, clotting time (PT/INR)
Facility: Coastal Communities Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $11
- Cash Discount Price: $24
- vs. Medicare Baseline: 2.56x 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 256% of the Medicare baseline (a markup of 156%). 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 |
|---|---|---|
| Altamed Health Services | $4 - $6 | 93% |
| Altamed Mcal Hmo (Ancillary) | $4 | 93% |
| Blue Shield | $4 - $16 | 93% |
| Caloptima | $4 - $6 | 93% |
| Central Health Plan Of California | $4 | 93% |
| Champion Health Plan | $4 | 93% |
| Choice Physicians Network | $4 | 93% |
| Citizens Choice Health Plan | $4 | 93% |
| Clever Care Health Plan | $4 | 93% |
| Easy Choice Health Plan | $4 | 93% |
| For Your Benefit | $4 | 93% |
| Health Net | $4 - $27 | 93% |
| Healthcare Partners | $4 | 93% |
| Healthcare Partners Sr Hmo | $4 | 93% |
| Heritage | $4 | 93% |
| Hollywood Presbyterian | $4 | 93% |
| Humana | $4 | 93% |
| Ihhi Reciprocity | $4 - $11 | 93% |
| Imperial Health Plan Of Ca | $4 | 93% |
| Innovative Integrated Health | $4 | 93% |
| Kaiser | $4 - $23 | 93% |
| Kpc Healthcare Inc | $4 - $6 | 93% |
| Medcare Partners | $4 | 93% |
| Medi-Cal Hmo/Non Contract | $4 | 93% |
| Medicaid / KanCare | $4 | 93% |
| Monarch | $4 | 93% |
| Onecare | $4 | 93% |
| Onecare Connect | $4 | 93% |
| Other Senior Non Contract | $4 | 93% |
| Prospect Health Plan | $4 - $6 | 93% |
| Scan Health Plan | $4 | 93% |
| Self Pay Ab774/Cbo Use Only | $4 | 93% |
| UnitedHealthcare | $4 | 93% |
| Us Dept Of Labor | $4 | 93% |
| Us Federal Marshall/Department Of Immigration | $4 | 93% |
| Velocity Provider Network Sr | $4 | 93% |
| Verda Health Plan Sr | $4 | 93% |
| Veterans Administration | $4 | 93% |
| Victim Of Violent Crime | $4 | 93% |
| Victoria Hospice | $4 | 93% |
| Brand New Day | $5 | 117% |
| Champus | $5 | 117% |
| County Of Orange/Custody/Advanced Medmgt | $5 | 117% |
| Coventry Auto Network | $5 | 117% |
| Coventry Wc | $5 | 117% |
| Interplan | $5 - $28 | 117% |
| Monarch Health Plan | $5 | 117% |
| Multiplan | $5 - $26 | 117% |
| Prime Health Srvs | $5 - $30 | 117% |
| Prime Health Srvs/Wc | $5 | 117% |
| Three Rivers | $5 | 117% |
| Velocity National Provider Network Wc | $5 | 117% |
| Veterans Evaluation Services | $5 | 117% |
| Workers Comp State Of California | $5 | 117% |
| Choc Health Alliance | $6 | 140% |
| County Of Orange | $6 | 140% |
| Family Choice | $6 | 140% |
| Heritage Provider Network | $6 - $22 | 140% |
| Staywell/Island Home Ins | $6 | 140% |
| Cigna | $8 - $24 | 186% |
| First Health | $8 - $19 | 186% |
| Three Rivers Network | $8 | 186% |
| Velocity National Provider Network Ppo | $8 | 186% |
| Magellan | $9 - $22 | 210% |
| Networks By Design | $10 - $26 | 233% |
| Networks By Design Wc | $10 - $26 | 233% |
| Healthsmart | $11 - $28 | 256% |
| Prime Health | $11 - $28 | 256% |
| Pnoa-Provider Network Of America | $12 - $30 | 280% |
| Aetna | $13 | 303% |
| Prime Health Srvs/Network | $13 - $31 | 303% |
| Lucet Behavioral Health Sr | $15 - $37 | 350% |
| Managed Health Network | $15 - $37 | 350% |
| Other Insurance Loa | $15 - $37 | 350% |
| Other Non Contracted Plans | $15 - $37 | 350% |
| Private Pay | $15 - $37 | 350% |
| Us Behavioral Health Plan | $15 - $37 | 350% |
| Vitas Hospice | $15 - $37 | 350% |