CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Sherman Oaks Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $4
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Sherman Oaks Hospital is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 4929 Van Nuys Blvd, Sherman Oaks, CA.
Cash / Self-Pay
$4

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: $4 (93%)
Insurance Median: $5 (117%)
Cash: $4 (93% 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
Aids Healthcare Foundation $4 93%
Alignment $4 93%
Blue Shield Of Ca, Va $4 93%
Blue Shield Of Promise $4 93%
Brand New Day $4 - $6 93%
Elite Health Plan $4 93%
Health Net Of Ca $4 - $6 93%
Imperial Health Plan $4 93%
L.A Care Health Plan $4 93%
Managed Health Network $4 93%
Medicare (plans) $4 93%
Molina $4 93%
Renal Payer Solutions $4 93%
Traditional Medi-Cal $4 93%
Tricare $4 93%
Usa Senior Care Network $4 93%
Aetna $5 117%
Americas Choice Provider Network $5 117%
Blue Cross Blue Shield $5 117%
Ca Foundation For Medical Center $5 - $6 117%
Corvel $5 117%
Employer Direct Healthcare $5 - $6 117%
Healthsmart Preferred Network $5 117%
Multiplan $5 117%
Naphcare $5 - $7 117%
Prime Health Services $5 117%
Provider Network Of America $5 117%
Provider Select $5 117%
Three Rivers $5 117%
Worker Comp $5 - $6 117%
Zelis Healthcare $5 117%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4929 Van Nuys Blvd, Sherman Oaks, CA 91403
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals