Blood test, clotting time (PT/INR)
Facility: Boulder Community Health
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $29
- Cash Discount Price: $43
- vs. Medicare Baseline: 6.76x 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 676% of the Medicare baseline (a markup of 576%). 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 |
|---|---|---|
| UnitedHealthcare | $2 - $4 | 47% |
| Aetna | $3 - $168 | 70% |
| Blue Cross Blue Shield | $3 - $115 | 70% |
| Health Spring | $3 | 70% |
| Humana | $3 - $4 | 70% |
| Clear Spring | $4 | 93% |
| Devoted Health | $4 - $77 | 93% |
| Medicare (plans) | $4 - $73 | 93% |
| Rocky Mountain Health Maintenance Organization | $4 | 93% |
| Select Health Colorado Public Option | $4 - $73 | 93% |
| Select Health Value Network | $4 - $73 | 93% |
| Cigna | $5 - $154 | 117% |
| Multiplan | $7 - $135 | 163% |
| Phcs | $7 - $135 | 163% |
| Kaiser Public Option | $8 | 186% |
| Kaiser | $10 | 233% |
| Kaiser Ppo | $10 | 233% |
| Rocky Mountain Health Maintenance Organization Private Plan | $17 - $135 | 396% |
| Integrated Health Plans Bch | $18 - $145 | 420% |
| Casualty Management Network, Prime Health Services Behavioral Health | $20 - $164 | 466% |
| Mines And Associates | $20 - $164 | 466% |
| Three Rivers Provider Network | $20 - $164 | 466% |
| Zelis (Profee) | $20 - $164 | 466% |
| Casualty Management Network, Prime Health Services Community Medical Associates | $22 - $174 | 513% |
| National Preferred Provider Network | $22 - $174 | 513% |
| Rockport Healthcare Group Bch | $22 - $179 | 513% |
| Rockport Healthcare Group Community Medical Associates | $22 - $174 | 513% |
| Usa | $22 - $174 | 513% |
| Health Management Network Bch Community Medical Associates | $23 - $185 | 536% |
| Health Management Network Community Medical Associates | $23 - $185 | 536% |
| Health Payors Organization | $23 - $183 | 536% |
| National Provider Network | $23 - $187 | 536% |