Blood test, clotting time (PT/INR)
Facility: Shriners Hospitals for Children Northern Calif
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $5
- Cash Discount Price: $37
- vs. Medicare Baseline: 1.17x 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.
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 |
|---|---|---|
| Amerigroup Nv | $2 | 47% |
| Ambetter / Centene | $3 - $7 | 70% |
| Health Plan Of Nv | $3 | 70% |
| Aetna | $4 - $5 | 93% |
| Amerigroup Tx | $4 | 93% |
| Cigna | $4 | 93% |
| Coventry Cares Ky | $4 | 93% |
| Gateway Health Plan | $4 | 93% |
| Humana | $4 | 93% |
| Medicaid / KanCare | $4 | 93% |
| Molina Healthcare Of Ky | $4 | 93% |
| Molina Healthcare Of Ms | $4 | 93% |
| Northbay Healthcare | $4 | 93% |
| Providence Health Plan | $4 | 93% |
| Soonercare | $4 | 93% |
| UnitedHealthcare | $4 - $6 | 93% |
| Amerihealth Caritas Nc | $5 - $7 | 117% |
| Amerihealth Caritas Sc | $5 | 117% |
| Blue Cross Blue Shield | $5 - $6 | 117% |
| Caresource Of Ga | $5 | 117% |
| Caresource Of Oh | $5 | 117% |
| Central California Alliance For Health | $5 | 117% |
| Health Net Of Ca | $5 | 117% |
| Health Plan Of San Joaquin | $5 | 117% |
| Healthchoice Of Oklahoma | $5 | 117% |
| Kaiser Permanente | $5 - $100 | 117% |
| Molina Healthcare Of Ca | $5 | 117% |
| Partnership Healthplan Of Ca | $5 | 117% |
| Sutter Medical Foundation | $5 | 117% |
| Wellcare Of Ga | $5 | 117% |
| Sana Benefits | $6 | 140% |
| Dignity Health | $536 | 12494% |