Blood test, clotting time (PT/INR)
Facility: John Muir Behavioral Health Center
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $25
- Cash Discount Price: $23
- vs. Medicare Baseline: 5.83x 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 583% of the Medicare baseline (a markup of 483%). 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 |
|---|---|---|
| Blue Shield Hmo [1006103] | $1 - $166 | 23% |
| Blue Shield Ppo [1006104] | $1 - $166 | 23% |
| Blue Shield-Network [1006026] | $1 - $166 | 23% |
| Contra Costa County Jail [1012104] | $1 - $152 | 23% |
| Federal Correction Institute [1062104] | $1 - $152 | 23% |
| Fortified Provider Network [1063104] | $1 - $152 | 23% |
| Galaxy Health Network [1064104] | $1 - $152 | 23% |
| Health Management Network [1066104] | $1 - $152 | 23% |
| Healthsmart - Pka Interplan [1031104] | $1 - $152 | 23% |
| Hospice Of East Bay [1085104] | $1 - $152 | 23% |
| Humana | $1 - $152 | 23% |
| Integrated Health Plan [1075104] | $1 - $152 | 23% |
| Medigap [1036001] | $1 - $152 | 23% |
| National Provider Network/Plancare America [1069104] | $1 - $152 | 23% |
| Networks By Design [1084104] | $1 - $152 | 23% |
| Pponext [1072104] | $1 - $152 | 23% |
| Sutter Preferred Health Plan [1044104] | $1 - $152 | 23% |
| Three Rivers Provider Network [1073104] | $1 - $152 | 23% |
| Aetna | $2 - $207 | 47% |
| Aps Healthcare [1003103] | $2 - $207 | 47% |
| Beacon Health Strategies [1005103] | $2 - $276 | 47% |
| Blue Cross Blue Shield | $2 - $207 | 47% |
| Brms [1091104] | $2 - $207 | 47% |
| Carecentrix [1011001] | $2 - $256 | 47% |
| Carelon Behavioral Health [1050104] | $2 - $190 | 47% |
| Cigna | $2 - $259 | 47% |
| Delta Health Systems [1032104] | $2 - $207 | 47% |
| Donor Network West [1008103] | $2 - $256 | 47% |
| Empire Plan [1092104] | $2 - $207 | 47% |
| Generic Commercial/Indemnity [1017001] | $2 - $256 | 47% |
| Health Net Hmo [1028103] | $2 - $190 | 47% |
| Health Net Ppo [1028104] | $2 - $190 | 47% |
| Health Net-Network [1028026] | $2 - $190 | 47% |
| Healthcomp [1089104] | $2 - $207 | 47% |
| Kaiser Hmo [1033103] | $2 - $207 | 47% |
| Western Health Advantage Hmo [1053103] | $2 - $256 | 47% |
| Alignment Health [1177113] | $4 | 93% |
| Care 1St Health Plan [1094113] | $4 | 93% |
| Caremore [1171113] | $4 | 93% |
| Essence Healthcare [1049128] | $4 | 93% |
| Medicare (plans) | $4 | 93% |
| Generic Hmo [1018103] | $5 | 117% |
| Generic Ppo [1021104] | $5 | 117% |