CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Adventist Health Tehachapi Valley

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $7
Cash Discount Price: $20
vs. Medicare Baseline: 1.63x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Adventist Health Tehachapi Valley is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.63x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$20

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $20 (466%)

Insurance Median: $7 (163%)

Cash: $20 (466% of Medicare)

Ins. Median: $7 (163% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Shield Epn- All Other Plans	$1 - $110	23%
Centivo - All Plans	$1 - $112	23%
Kaiser Ip/Op Only- All Other Plans	$1 - $85	23%
Western Grwrs/Pinnacle - All Plans	$1 - $110	23%
Ah Employee Health Plan - All Plans	$2 - $138	47%
Blue Cross Blue Shield	$2 - $151	47%
Blue Shield Non-Epn	$2 - $130	47%
Healthnet Mcare	$2 - $50	47%
Klhp-Kern Legacy Epo -All Other Plans	$2 - $130	47%
Medicare (plans)	$2 - $50	47%
Network Providers- All Plans	$2 - $63	47%
Tricare	$2 - $50	47%
UnitedHealthcare	$2 - $128	47%
Universal Ipa Mcr Adv Op/Profee Only-All Other Pla	$2 - $50	47%
Bc Mcal	$3 - $5	70%
Cigna	$3 - $204	70%
Coventry- All Plans	$3 - $235	70%
Healthnet Medi-Cal	$3 - $6	70%
Healthnet- All Other Plans	$3 - $201	70%
Kaiser Medi-Cal Ip/Op Only	$3 - $5	70%
Khs-Kern Hlth Systm Mcal	$3 - $6	70%
Medi-Cal	$3 - $5	70%
Universal Ipa Mcal Op/Profee Only	$3 - $5	70%
Aetna	$5 - $23	117%
Oscar Health Plan- All Plans	$5 - $7	117%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $20.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Tehachapi Valley is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85610.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.