CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Glenn Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $41
Cash Discount Price: $28
vs. Medicare Baseline: 9.56x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Glenn Medical Center is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 9.56x the Medicare baseline. Located in 1133 W Sycamore St, Willows, CA.

Cash / Self-Pay

$28

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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: $28 (653%)

Insurance Median: $41 (956%)

Cash: $28 (653% of Medicare)

Ins. Median: $41 (956% 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 956% of the Medicare baseline (a markup of 856%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Ca Health And Wellness - All Plans	$5	117%
Medi-Cal	$5	117%
UnitedHealthcare	$11 - $94	256%
Blue Cross Blue Shield	$15 - $106	350%
Humana	$15 - $46	350%
Blue Shield Exch	$31 - $95	723%
Cigna	$32 - $100	746%
First Health - All Plans	$32 - $100	746%
Healthnet - All Plans	$32 - $100	746%
Beech Street - All Plans	$34 - $106	793%
Blue Shield Ppo/Hmo - All Other Plans	$34 - $106	793%
Dept Of Corrections - All Plans	$34 - $106	793%
Galaxy Health Network - All Plans	$34 - $106	793%
Interplan - All Plans	$34 - $106	793%
Pacific Health Alliance - All Plans	$34 - $106	793%
Pponext - All Plans	$34 - $106	793%
Superior Ca Ppo - All Plans	$34 - $106	793%
Integrated Hp - All Plans	$35 - $109	816%
Health Mgmt Network - All Plans	$36 - $112	839%
Networks By Design - All Plans	$36 - $112	839%
Three Rivers - All Plans	$36 - $112	839%

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 $28.
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 Glenn Medical Center 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.